Piper methysticum (it is called Macropiper methysticum in most recent botanical works, but I retain the older name by which it is best known in homoeopathy) furnishes the root called Kava in Polynesia. The natives use it as a stimulant, either chewing the root or drinking a beverage made of it before undertaking any important business or religious rites. Excessive indulgence in it produces a skin disease like leprosy, called at Tahiti Arevareva. Lutz (quoted H. W., xxviii. 175) describes the disease as observed amongst natives of the Sandwich Islands: "The skin, particularly that of the extremities, assumes the appearance of well-marked ichthyosis, associated with a certain degree of atrophy, such as is observed in senile skin. There is an absence of inflammatory symptoms." The mental symptoms of the" Intoxicating Pepper" (µέθνσις, drunkenness) are the most interesting feature of the drug's action. W. N. Griswold proved the third and second dilutions, and developed a large number of nervous, mental, and brain symptoms, among which are some which have proved to be keynotes. The drug causes a feeling of buoyancy, as if every nerve was strung up to the highest pitch; feels he can work without fatigue, quickly followed by a feeling of tired brain, and over-sensitiveness to all external impressions. Mental tension; feeling as though the head were enlarged even to bursting. The mental symptoms, excitement or depression, and the headache, were > by diversion of mind. This is one of the keynotes, and it has served to indicate Piper m. in connection with other symptoms. Griswold cured a case having burning in chest, > by diverting mind (Org., i. 229); and three cases having: "Agonising pain, with tossing, twisting, and writhing; patient driven irresistibly to change position, which generally gives little or no >." This italicised passage is the second keynote of Piper m. These cures were with the 1x or Ø tinctures. Skinner gave fractional doses of Ø tincture in water to a highly excitable young girl who had severe toothache and earache, and had worn out her family by the incessant day and night attendance she required. The pains were dragging, heavy, < at night in bed, and after or when eating, "forgets all about her pains if amused with anything, but directly she is tired of it she exclaims, 'Oh, my tooth or ear!' " In addition she had "Agonising pain with tossing, twisting, and writhing; irresistibly driven to change position." The patient slept well that night the first time for a fortnight, and had no more pain. The remaining swelling was removed by Puls. 200. Skinner also reports this case: Miss R., 20, has toothache in a decayed molar, > if attention is diverted by anything sufficiently exciting. When pain is at all violent she has no rest in any position, must keep continually changing it. Piper m. 500 (F. C.) was given, and there was relief very soon after the first dose. A few doses completely removed the pain (Org., i. 299).—Piper m. has much dizziness and vertigo; > on closing eyes. The forehead was full, "solid with pain;" this shifted to occiput and cervical spine, where it became a compression, extending as a constricting sensation to stomach and chest. The sensation of enlargement of head was marked and persistent. Farrington says convulsions simulating catalepsy are produced. Cerna (quoted H. W., xxvi. 556) as a result of his investigations found Piper m. a general and local anaesthetic. It diminishes reflex action by its action on the cord, and kills by paralysing respiration. Cerna illustrated its relationship to Cubeba by citing cases of gonorrhoea, acute and chronic cystitis, gleet, prostatorrhoea, vaginitis, cured with it. The provings give the indications. The symptoms were < before meals (sour eructations); reading and thinking; urinating (burning in urethra); walking. Going down stairs = symptoms to rush up. > Moving; diverting mind; open air; closing eyes (vertigo).