Ptelea Trifoliata

Hop Tree; Wafer Ash. Rutacex.

An indigenous shrub, from six to eight feet high, growing west of the Alleghanies.

The tincture is prepared from the fresh bark.

Provings by Hale, Trans. Am. Inst. Horn., 1868. The provers were Nichol, Fish, Train, Burt,Cowles,Cowperthwait, Lutes, Pierce, Marshall, Parsons and Hayward; fragmentary proving by Williamson, Trans. Amer. Inst., 1870, sec. 2, p. 381.

Clinical Authorities. — PUyriasis versicolor, Hale; Erysipelas (two cases), Miller, Hale's Monograph.

^ Mind. I I Marked forgetfulness.

Memory weak ; intellect slow ; by collecting thoughts could recall things read many years ago.

I I Dull and stupid feeling.

Inability to concentrate thoughts, they seem to be chasing each other through the brain.

Disinclined to mental work, with languor rather than inability.

I I Malaise of body and mind.

I I Aversion to society ; a wish to be alone.

1 I Fretful and irritable at very slight causes.

I I Annoyed and irritated by ordinary conversation ; intol- erance of noise.

Nervous, irritable; starts at the sound of a voice.

I General depression of spirits.

Sad, irritable; hurried manner, but dazed and confused, with muddled feeling in head. ^ Sensorium. Dazed, confused, as in a bilious attack; raises a bitter fluid.

I I Feels sick and faint.

Vertigo, < turning head or from sudden motions ; with

567 PTELEA TRIFOLTATA.

dulness and languor, rumbling about navel; nausea, griping, aching in stomach ; < when writing, rising or in a warm room. II Giddiness of head, and when walking reeling as if intoxicated. ^ Inner Head. Dull aching in forehead, with depression and sour stomach ; racking pain, with hurried manner and red face. Pain from forehead to root of nose; sensation of nail

driven into brain ; < in morning on rising. Racking frontal headache, with heat of face and head,

and great desire to hurry his business. I I Frontal headache all day ; pressing from within

outward. I I Headache over eyes. Throbbing over one eye. Darting pains over 1. eye, deep into head. Hot flushes and pain in top of head and eyes. Pain in 1. temple running across to right. 1 I Sudden, pressive pains in temples, < in right._ I I Piercing pain shooting through temples, with increased

headache and nausea. I I Frontal and occipital headache.

Headache in occipital region, passing to frontal over eyes. Pressive feeling at base of brain, compared to the bruised

headache of Ipec. I I Shooting pains in head, before rising in morning. I [Constant dull headache, < by going up-stairs and by

walking. I 1 Headache while reading.

Headaches < from mental exertion, moving eyes, stoop- ing, walking, noise, warmth and on waking. Headache in bones of skull. ■ Bilious headache. ' Sight and Eyes. 1 1 Heavy feeling over eyes.

I I Pain in eyes. ''Hearing and Ears, l l Sensitiveness to sounds ;_ impres- sion of sounds last heard continues for a long time. Intolerance of loud talking. Ringing in ears; slight giddiness. ^ Smell and Nose. Breath seems so hot that it burns nostrils. Nasal passages sore.

Sneezing. .

^ Upper Face. Expression sickly, pale, especially around eyes ; color yellow, skin dry and hard. 1 1 Burning heat of cheeks and face. Heat of head and face, especially of forehead.

PTELEA TRIFOLIATA. 568

I 1 Yellowish face, with dry hot skin.

Sickly paleness of face, especially around eyes.

I I Pressure at root of nose. ^^ Teeth and Gums. Teeth feel as if elongated.

Carious teeth sensitive ; gums sore. " Taste and Tongue. Taste : sour, mornings ; bitter.

I I Frequent bitter taste in mouth, with dryness.

Food seems tasteless.

I I Fine prickling sensation over whole surface of tongue.

I I Coating : white fur, tongue swollen ; yellow, feels rough ; papillae red and prominent; brown, yellow, dry. ^^ Inner Mouth. Dry, with bitter taste.

I I Great dryness of mouth and throat.

Saliva profuse ; drooling at night. '^ Throat. Hawking of mucus from pharynx ; lips and tongue dry.

I I Roughness of fauces with nausea.

I I Soreness and inflammation of fauces; soft palate and

uvula (< r. side). " Appetite, Thirst. Desires, Aversions, i i Voracious ap- petite; food had not its natural taste; pain in epigas- trium following every meal ; despondency.

■ Appetite poor, with muddled feeling or pains in liver. Thirst; or no thirst, with bitter taste.

Craves acid food.

■ Repugnance to animal food and rich puddings, of which

he is ordinarily fond ; to butter and fatty foods ; even a small quantity aggravated epigastric pain. ^^ Eating and Drinking. Worse from cheese, meat, pud- ding, etc.

■ Hepatic and gastric symptoms < after meals.

*^ Hiccough, Belching, Nausea and Vomiting. 1 1 Eructa- tations : sour, bitter : tasting of rotten eggs. Nausea: rising of a bitter fluid, confused head, dizzy, sweat on forehead, bilious ; with distress in umbilical region and headache ; with heat of skin and profuse perspiration on forehead after dinner; and vomiting, without relief from frontal headache.

II Persistent nausea and vomiting, with giddiness and unsteadiness of legs ; > by walking.

'^ Scrobiculum and Stomach. ■ Pressure as of a stone at pit of stomach, > by a light meal.

■Sense of weight and fulness even after a moderate meal.

Distress in epigastrium and r. hypochondrium, with draw- ing pains in fingers and ankles.

I I Stomach feels empty after eating ; a sensation of gone- ness.

I 1 Empty feeling ; faint feeling in stomach ; sour risings.

I I Pain in epigastrium, with nausea.

569 PTELEA TRIFOLIATA.

I Burning distress; oppression; vomiting; chronic gastric catarrh.

Griping, cutting pains in epigastrium ; pressure causes nausea.

I I Griping in epigastric region, with dryness of mouth, yellow-coated tongue and a bitter taste.

I I Griping, contractive pain in stomach, moving down- ward.

iGastralgia.

■ Obstinate chronic dyspepsia.

I Chronic gastritis; a constant sensation of corrosion, heat and burning in stomach, with vomiting of ingesta, con- stipation and afternoon fever.

■ Gastric symptoms < after meals.

'^ Hypochondria. ' ' Constant feeling of weight in both hypo- chondria when walking ; a dragging pain.

I I Occasional pains in r. hypochondrium, shooting down- ward.

I I Sharp pains in r. hypochondrium.

I I Awoke with hard, aching distress in base of liver,

■ Weight, aching distress in hepatic region; dull pain,

heaviness, > lying on r. side ; turning to 1. causes a

dragging sensation. Sharp, cutting pain in liver, < from deep inspiration. I I Liver swollen and tender to a light touch.

■ Liver swollen, sore on pressure, causing dull and aching

pain or stitches ; griping in bowels ; clothes feel too tight. I IJaundice with hypersemia of liver; stools generally brown or grey, with considerable odor.

■ Congestion of liver; "chronic hepatitis.

Hepatic and gastric symptoms, < towards morning, awak- ing at 4 o'clock.

I I Severe aching distress in 1. hypochondrium.

I I Tenderness of splenic region, with soreness on pressure. '^ Abdomen. Bloating with weight on stomach.

I I Abdomen swollen and tender with severe splenic pain.

I I Rumbling in bowels and bloating, with tenderness on pressure.

Feeling of warmth in abdomen.

Aching distress in bowels, back and legs.

I I Aching of bowels while walking.

Pulsation in umbilical region, synchronous with heart.

I I Soreness of abdomen, < by motion, > supporting it with hands.

1 I Pain and soreness across abdomen and in epigastrium, < by standing and sitting erect and > by stooping forward.

PTELEA TRIFOLIATA. 570

1 I Severe abdominal pain near umbilicus ; < on motion.

I I Stitches in abdomen, > by pressure.

I I Frequent drawing pains in epigastric and umbilical regions.

Griping, colicky pains; heavy aching ; throbbing; about navel.

I I Colic, bitter taste; rumbling and discharge of wind from bowels.

I I Pain in hypogastrium and bladder, with headache, in- termitting during paroxysms.

I I Retraction of abdomen with pulsations isochronous with heart.

I I Chronic intestinal catarrh.

1 I Ascites, probably from hepatic disease. ^^ Stool and Rectum, l l Sudden and unexpected urging to go to stool, which was diarrhoeic with slight tenesmus, accompanied by sweat on forehead and head.

■ Diarrhoea: bilious, thin, fecal, dark, offensive, even cadav- erous in smell, or sulphuric; with tenesmus; preceded by griping pains and rumbling ; smarting in anus.

I I Chronic diarrhoea.

I I Constipation with a continual urging in rectum.

I I Constant ineffectual urging to stool; a continual press- ure in rectum.

Continual urging, with pressure on rectum ; with scanty or absent stool ; rectal torpidity.

I I Constant urging to stool, with rumbling in bowels, all day.

I I Small, hard stool, with much straining.

I I Hard and difficult stool, followed by smarting in anus.

Constipation ; passes balls of haTdened feces.

I Constipation and diarrhoea alternately.

^'Urinary Organs. lUrine: high-colored; yellowish-red;

of a deep color and scalding slightly on its passage;

clear or deep reddish-yellow, scanty ; deposit of epithelia,

phosphates and urates ; scalding, scanty and difficult

of retention ; smarting in urethra during and after

micturition.

^^ Male Sexual Organs. Sexual desire increased ; later lost.

^^ Voice and Larynx. Trachea and Bronchia. 1 1 Great

hoarseness; inability to speak aloud. ^® Respiration. L l Uneasiness and difficulty in breathing.

Feeling of pressure on lungs and of suffocation when lying on back ; on awaking 1 a.m.

1 I Pressure on lungs with a sense of suffocation.

I I Dyspnoea; walls of chest feel as if they would sink in. I I Asthma (from retrocession of erysipelas). ^^ Inner Chest and Lungs. Uneasiness, difficulty in breath-

571 PTELEA TRIFOLIATA.

ing, dull pain in r. infraclavicular region, hacking

cough; dulness on percussion (following gastric and

hepatic symptoms). 1 I Phthisis with purulent expectoration of sweetish taste

and hectic form (probably a bronchial catarrh). I I Hectic fever with purulent expectoration of a sweetish

taste, but without any other chest symptoms than a

slight mucous rhonchus and sibilant rale. ^^ Heart, Pulse and Circulation. 1 1 Cramplike pain in cardiac

region. I I Pulse accelerated and intermittent. ^^ Neck and Back, l ' Drawing aching pains in 1. scapula and

shoulder joint. I iDull backache every morning on waking. I I Hard aching distress in dorsal region, for an hour in

morning. Aching distress in back, bowels and legs; rumbling of

wind. I I Severe aching in lumbar and sacral regions Lumbar pains ; severe aching distress, soreness on awaking,

or awakes him at 4 a.m. ^^ Upper Limbs, ll Hands and fingers cold, numb, clumsy

and stiff. I I A tickling prickling in fingers and hands, like that pro- duced by electricity. 1 I A prickling numbness in hands, which seem larger

than usual and clumsy. ^^ Lower Limbs, n Great weariness of lower limbs with

trembling. I I Aching pains in back part of thighs. I I Constant aching distress in calves of legs. ^' Limbs in General. Aching bruised feeling in muscles

and joints on waking ; drawing pains in gastro-hepatic

region. I I Hands and feet hot, dry and feverish. ^'E-est. Position. Motion. Supporting abdomen with

hands: soreness >. Sitting erect: soreness of abdomen >. Lying on back : suffocation. Lying on r. side: liver >. Standing: soreness of abdomen <. Stooping: headache < ; soreness of abdomen >, Motion : sudden, causes vertigo ; of eyes, headache < ;

soreness of abdomen < ; abdominal pains <. Rising: vertigo <. Turning head : vertigo <•

Walking : giddiness < ; constant dull headache < ; nau- sea, vomiting and giddiness, weight in both hypochon- dria; aching of bowels.

PTELEA TPvIFOLIATA. 572

Going up stairs : dull headache <.

Writing : vertigo <. ^^ Nerves. Restless, uneasy ; malaise.

I I Great languor and indifference to duties.

I I Loss of energy; languor and depression of spirits.

Feeling of weaknesi3, languid, irritable ; sick, faint sen- sations, as in bilious patients.

I iVery languid and faint, with flushed face and feverish.

I I Aching distress in all the joints, with great languor.

I I Great lassitude and weariness, with a disposition to hurry through duties.

I I Extreme weakness of limbs, brain, memory, thought and will as if from a powerful and all pervading disease. ^^ Sleep. Heavy sleep.

Awoke 2 A.M., restless ; headache, etc.

At 4 A.M., aroused by gastric and hepatic symptoms.

I I Sleep broken and restless and disturbed by frightful or annoying dreams ; awaking in a profuse perspiration.

I I Nightmare.

1 I Languid on awaking and unrefreshed. ^^ Time. 1 a.m. : suffocation.

2 A.M. : awoke restless, headache.

4 A.M. : aroused by gastric and hepatic symptoms.

Morning : pain from forehead to root of nose < ; before rising shooting pains in head ; hepatic and gastric symp- toms <, awaking at 4 a.m.

Afternoon :. fever.

All day : frontal headache ; urging to stool and rumbling in bowels ; feverish heat.

Night : drooling. ^' Temperature and Weather. Wants to be near fire : chil- liness.

Warmth: headache < ; spots on limbs <.

Warm room: vertigo <.

Generally > in open air (except lung); < in warm room. ^" Fever. Chilliness: shivering ; with stool ; wants to be near fire.

Dry, general heat ; < face and hands ; irritable, intolerant

of noise. I I Hot, dry feeling on body, with cold feet. .

Hot flushes and slight headache ; feverish hot head, dull

frontal headache. 1 I Feverish heat, lasting all day, with pains in limbs and nausea.

Sweat profuse on awaking ; on forehead during stool or

with raising of a bitter fluid. I I Tertian ague, with profuse vomiting of bilious matter.

573 PTELEA TRIFOLIATA.

I Attacks of quartan ague, continuing for two years, re- sisting many remedies. *^ Locality and Direction. Right : pressive pain in temple < ; soreness of uvula < ; fauces < ; distress in hypochon- drium ; occasional pains in hypocbondrium ; sharp pains in hypocbondrium; dull pain in hepatic region > lying on side; pain in infraclavicular region; white blisters on red base on ear.

Left: darting pains over eye ; pain in temple; turning to side causes a dragging sensation; aching distress in hypocbondrium ; pain inl. scapula and shoulder joint.

From wdthin outward :■ pressing frontal headache. *^ Sensations. Reeling as if intoxicated ; as of a nail driven into brain ; teeth as if elongated ; as of a stone at pit of stomach; as if walls of chest would sink in.

Pain: from forehead to root of nose; in top of head and eyes; from 1. temple to r. ; in eyes; in epigastrium; In liver ; in r. hypocbondrium ; in hypogastrium and bladder.

Racking pain : in brain.

Severe pain: near umbilicus.

Sharp pains : in r. hypocbondrium.

Cutting: in epigastrium; in liver.

Darting : over 1. eye, deep into head.

Piercing : through temples.

Shooting: in head.

Stitches : in abdomen.

Pricking pain : in throat.

Prickling: all over tongue; in fingers and hands.

Drawing : in epigastric and umbilical region ; in gastro- hepatic region.

Dragging : in hypochondria.

Cramplike pain : in cardiac region.

Griping: in epigastric region ; in stomach; in bowels.

Burning: in stomach.

Smarting : in anus ; in urethra.

Soreness : of fauces ; in epigastrium ; of abdomen.

Tenderness : of splenic region.

Dull pain in head ; in hepatic region ; in liver ; in r. infra- clavicular region ; in back.

Aching : in stomach ; in forehead ; in frontal and occi- pital regions ; in hepatic region ; of bowels; about navel; in lumbar and sacral regions ; in back part of thighs ; in muscles and joints.

Drawing, aching pains : in 1. scapula and shoulder joint.

Aching distress : in umbilical region ; in hepatic region ; in 1. hypocbondrium; in bowels, back and legs; in dorsal region; in calves; in all joints.

PTELEA TRIFOLIATA. 574

Pressive pains : in temples.

Pressure: in forehead; at base of brain; at root of nose; at pit of stomach ; in rectum; on lungs.

Heavy feeling : over eyes.

Fulness : in stomach.

Weight: in stomach ; in both hypochondria.

Goneness: in stomach.

Empty feeling: in stomach.

Faint feeling: in stomach.

Throbbing: over one eye; about navel.

Weariness : of lower limbs

Heat: efface and head; of skin; in stomach.

Itching : all over.

Roughness: of fauces.

Dryness : in mouth ; of throat ; of lips. " Tissues. Mucous membranes are congested and irritated, with sense of roughness, smarting or prickling; causes congestion of liver, stomach and bow^els and secondarily of lungs ; is indicated briefly when there are irritability, and dull, confused frontal headache ; bitter taste, eruc- tations like rotten eggs or bitter; swollen liver, relief from lying on r. side, bilious stools; languor; muscular soreness. ^^ Skin. Itching all over as from flea-bites.

^Vliite blisters on a red base on r. ear, discharging a watery fluid ; later desquamation or pus and scabs form ; boils.

Spots on limbs red, later purple ; < when warm or ex- cited ; annoying itching; on disappearing they leave 3'ellowish marks like bruises.

I I A peculiar reddish, clouded appearance of entire surface of skin, lasting two days.

I I Erysipelas; quinia and iron had been used in large doses without success,

I I Pityriasis versicolor ; eruption on all parts of body ex- cept hands and face. '^ Stages of Life, Constitution. Erysipelas ; two cases.

A middle-aged man; pityriasis versicolor. ■•^ Relations. Compare : Other Rutacese, Arnic, Bryon., Chelid., Nux vom., Berber., Podoph., Hydrast., Mercur.

575 PULSATILLA.