Chimaphila Umbellata

[PIPSISSEWA. NATURAL ORDER, ERICACE^.]

This beautiful small evergreen, also called wintergreen, prince's pine, ground holly, etc., can be found in all parts of the United States and Canada. It grows in the woods, loving a dry soil ; its dark green, shining leaves are from two to three inches long and about one-half to three-fourths of an inch wide. It flowers in July, bearing from four to seven light purple flowers.

The medicinal properties of the plant are common to all its parts. The best preparation is a tincture made from the fresh, bruised whole plant, gathered in July. An infusion of the fresh or dried plant is also frequently used.

Up to a recent date, domestic practice monopolized this, in some diseases really valuable remedy. Prof. S. A. Jones (Am. Observer, June, 1873) quotes from old writers, dating back to the year 1578, showing that even at that early date, some of the real or supposed virtues of this modest little plant were well known.

Writers of recent date of the physiological schools mention the pipsissewa. They differ in their definition of its sphere of action ; but agree upon its possessing remarkable efficiency as a diuretic.

We have no extensive proving of the remedy. The following short provings, reported by Professor Gatchell, are taken from the Am. Observer, Feb., 1876 :

692 CHIMAFHILA UMBELLATA.

Sensation of swelling in the arm-pits; pain from the arm-pits to the scapulae. Stinging in the labia, as if boils were there. Sensation like that in the arm-pits. Dull, heavy pain in the whole front and top of the head. (Good for mild, amiable patients.)

Excitement of the sexual system. The blood feels as if it were heated, with prickling. Colic-like pains between the pubes and navel. Pain in and above the forehead.

Pain in the bones of the forefinger. Sharp pains and heat deep in the head, unfitting him for exertion. Needle-like pains in the sacrum. Similar pains in the hip-bones.

Exceedingly hot, as if the blood were boiling, but cannot sweat. The skin feels dry. Wants the head pressed. The right arm feels as if paralyzed.

Very nervous, cannot bear anything at all. Hot, irritable, restless. He thinks a dis- eased state of the blood irritates the skin, as before the eruption of erysipelas, scarlet fever or measles. Itches terribly.

Pain in the bowels. Feels as if the neck were too small and tired, and that the medicine is adapted to refined, sensitive, intellectual persons. After the colic pains a diarrhoea, not very weakening. The limbs feel as if distended; a feeling like that from erysipelas.

Bowels hard and swollen. Thinks the glands are swollen. Bowels very painful, sore and hard. Feels as if he had dropsy of the abdomen.

Followed next day by pains as in all the bones, and extreme, gnawing hunger.

The main value of chimaphila consists in its strongly-marked action upon the urinary apparatus, especially upon the kidneys. It has acted with unusual promptness in catarrhal inflammations of the urinary passages. Our knowledge of the remedy is, however, vague and unsatisfactory. The following cases may be suggestive :

CHRONIC CATARRH OF THE BLADDER.— Dr. E. M. Hale reports in the N. E. Med. Gazette, June, 1877, a case of chronic catarrh of the bladder cured by chimaphila. He says :

In the winter of 1875 I was consulted by a young married woman, aged twenty- four, who gave me a history of a cystic disease with which she had been troubled for years, and for which she had tried all kinds of allceopathic medication. The symp- toms were, very frequent and painful urination every two or three hours during the day and sometimes as often during the night. The pain was described as burning and scalding during urination, and spasmodic, like a tenesmus, after. There was sometimes a difficulty in starting the urine, requiring some straining.

But a small quantity was voided each time, and this was nearly always of a very high color, dark red or brown, and was intensely pungent and disagreeable in odor. This odor was noticeable when first emitted, proving that decomposition of the urine or something else occurred in the bladder. On allowing the urine to stand a few hours, it deposited a copious, leather-colored or ash-colored sediment, amounting to nearly one-eighth of the bulk of the urine. This sediment was very tenacious, and would pour out of the bottle in long strings.

The odor was fetid and ammoniacal. She had no uterine disease, but a moderate, vaginal leucorrhcea. She was thin and poorly nourished, appetite poor, bowels costive, and she was easily fatigued. After nearly a year's constant treatment, during which time she took chimaphila1 and s, without benefit, she received one ounce of the tincture of chimaphila in three ounces of simple syrup, of which solution she took a teaspoonful four times a day.

After taking it a week she reported that she was much improved, not only in the urinary symptoms, but her consti- pation was relieved, and her appetite improved. In another week the improvement was- rapidly progressing, the vaginal leucorrhcea was better than it had been for years, and the amount of sediment in the urine had greatly decreased. The medicine was con- tinued, three dose^ a day, and at the expiration of a month from the beginning of its use, she was cured.

CHIMAPHILA UMBELLATA. 693

DYSURIA, or painful micturition, has been successfully treated with it, even when other remedies of established reputation failed to relieve the difficulty.

IRRITABLE BLADDER.— It is also of value in the treatment to irritable bladder.

Dr. O. R. Long relates the case of a middle-aged lady, who was suddenly and without any apparent cause attacked with frequent and painful micturition. Upon standing, the urine, from the second day of the attack, deposited a mucous sediment. Cantharides, cannabis sativa and other remedies failed to relieve. Five drops of a solution of the tincture of chimaphila limb., in two drachms of water, were given. Improvement set in at once, and in twenty-four hours the patient was discharged cured.

He gives also the instance of a young married lady, in good health and not preg- nant, who, while at a party, was taken with a slight chill with inclination to very frequent and painful voiding of urine ; there was no increase in the beat of the pulse or in the temperature of the body. Apis, cantharides, camphora, copaivre balsamum, eupatorium purpureum were given for several days, when a teaspoonful of a solution of twenty drops of the tincture of chimaphila in one-third of a glassful of water was administered every hour, giving prompt relief and permitting the discharge of the patient in thirty-six hours.

GLEET. — Chimaphila has been recommended in the treatment of gleet, when the tenesmus, sediment of mucus in the urine, and other symptoms, indicate tne extension of the disease into the neck of the bladder. Also in

ELEMATURIA in consequence of severe and long-continued gonorrhoeal inflammation.

ALBUMINURIA may possibly be benefited by the exhibition of this drug, but we are not in the possession of reliable clinical experi- ence on this point.

Dr. Payne and, later, Dr. Hale attribute to chimaphila the power to cause atrophy of the mammae and of the testicles.

Dr. Hull had under his care a case of painful tumor of the mammae in a young, un- married woman. He concluded to test the power of chimaphila in her case. The medicine was prescribed on the ist of July (10 drops every four hours). On the 15th, the patient reported a diminution in size, not only of the tumor, but of both mammae. On the 13th of August the patient wrote " I think I am entirely relieved of my tumor. * * * Both breasts are much reduced in size."

A lady had enlarged lymphatic glands in the neck, of three years' duration. After a confinement they rapidly increased in size. Chimaphila arrested the further growth of the glands, suppressed the secretion of milk (re-established by the exhibi- tion of veratrum viride) ; and caused a decided lessening in size of both breasts, which have not yet assumed their previous fulness, and appear shriveled.

694 CINCHONA OFFICINALIS.