Podophyllum Peltatum

Podophyllum peltatum is the mandrake or May-apple, a plant that grows to the height of some two or three feet, with leaves spread out like an open hand. It is found mostly on the borders of woods. The parts used in medicine are the roots and fruit of the plant. When applied externally, Podophyllum produces a rawness of the skin, re- sembling intertrigo. If the powdered plant gets into the eyes it pro- duces a severe inflammation and even a perforating ulcer of the cornea.

The central point of attack of the drug, however, is in the abdomen. Shortly after it is taken there follow diarrhoea, colicky pains, the well- known morning stool pouring out like water from a hydrant, preceded by retching and vomiting and spasmodic contraction of the stomach, making the child scream out; a diarrhoea such as would make us think of Sulphur, Dioscorea, Bryonia, Natrum sulph., and a few other remedies. The stools are renewed immediately by eating, like Croton tig Hum, etc.

In addition to its intestinal action we find it acting on the liver, and here is the main use that is made of the remedy. It is indicated in the torpid or chronically congested liver. The liver is swollen and sensitive, and friction over the right hypochondrium relieves this sen- sation. The face and sclerotica become tinged yellow. There is bad taste in the mouth, evidently arising from the degeneration of food in the intestinal tract. The tongue is coated yellow or white, and takes

454 A CLINICAL MATERIA MEDICA.

the imprint of the teeth. The bile may become inspissated in the gall bladder, forming gall-stone; thus we find Podophyllum indicated in that tormenting disease, bilious colic. The stools are of the nature already mentioned; or they are constipated and clay-colored, showing the absense of bile. These symptoms of Podophyllum much resemble those of Mercurius. They have won for the drug the name of vege- table mercury. It is much less injurious, however, than is Mercury.

In constipation of bottle-fed babies Podophyllum will sometimes relieve. The stools are dry and crumbling.

Of the remedies having the symptom, the tongue takes the imprint of the teeth, Mercurius stands at the head of the list. Next to that we have Podophyllum, and then Yucca jilamentosa, and, finally, Rhus, Stramonium and Arsenicum metallicum.

Podophyllum also produces prolapsus recti with the diarrhoea. The rectum protrudes before stool (JVzcx vom. after), especially in the morn- ing. Podophyllum also seems to have the power of producing and cur- ing prolapsus of the uterus with attendant symptoms of bearing down in the hypogastric and sacral regions worse from motion, and neural- gia in the right ovary, extending down the anterior crural nerve, backache, retarded menses, thick transparent leucorrhcea and often coexisting with these, prolapsus recti.

As concordant remedies to Podophyllum in this prolapsus we have Nux vomica and Sepia, the indications for which I have already given you in a former lecture.

Very few would think of Podophyllum as a remedy for tonsillitis and yet it has some very clear cut indications in this affection. The trouble is apt to start in the right side and extend to the left, like Lycopodium. There is great dryness of the throat, aggravation from swallowing liquids and in the morning and pain going into the ear.

Podophyllum is a valuable remedy during dentition. It does not seem to act on the brain, yet it causes reflex cerebral irritation, whether this be from the abdominal symptoms alone or from the teeth. The symptoms which indicate it in addition to those already given are moaning and whining during sleep, not crying out with a sharp, sudden noise, as under Belladonna, but a sick cry; the child grates its teeth; the head is thrown back and rolled from side to side.

Next we find Podophyllum indicated in fevers, usually of a remittent type, particularly in bilious remittent fever. The drug does not pro- duce many characteristic symptoms during the chill, but during the fever the patient is sleepy and sometimes delirious.

LECTURE XLIV.

MINERAL KINGDOM.

I propose now to begin the study of the drugs obtained from the mineral kingdom. I have placed on the board {see next page) for your study the elements, arranged in order according to some of their relations, just as we find them in chemistry. I wish to explain here the general idea of the relation of drugs, and especially of those be- longing to the mineral kingdom. If you consult chemistry you will find that the elements hold to each other an electrical relation.

They hold to each other a relation of polarity as positive electric and neg- ative electric. Certain of these elements are emphatically negative, and others are just as positively positive. Some of the elements, as gold, silver, etc., hold a middle relation, being rather neutral. These I have placed at the neutral point of the magnet.

The advantage of this method of study will be seen as we proceed. The negative elec- trics are known to be conductors of light, the positive conductors of heat. The extreme effects in this respect are noticed at either pole, diminishing as we approach the curve of the magnet. Another fact which is well worth knowing is this general statement: the electro- negatives act on the bowels in the morning, and the chest in the after- noon: that is, they act upward on the body during the day.

Exactly the opposite holds true with the electro-positive. These act on the chest in the morning, and on the bowels in the latter part of the day. Most of you are acquainted with the morning diarrhoea of Sulphur, which hurries the patient out of bed. You know how the asthma of that remedy increases in the afternoon.

Taking the remedies at the other extreme, we have the Kali salts as examples; you know that they have aggravation of their chest symptoms in the forenoon, and of their bowel symptoms in the afternoon. This is, of course, a very general statement, but it may be of great use to you in enabling you to differentiate between drugs. Let me illustrate. You have a case of scrofula and you are obliged to decide between Sulphur and some salt of lime.

You will be astonished to see how similar are many of the symptoms of these two drugs. The very fact of the diarrhoea

A CIvINICAL MATERIA MKDICA.

Elect?'o-

Electro+.

Oxygen. Ozone. Nitric ac. Amyl nitr.

Sulphur. Selenium. Sulph. ac. Carboneum sulph.