Menispermum cocculus, Cocculus indicus, Cocculus suberosus, Anamirta cocculus." The seeds or berries are the parts used in medicine.
This substance was employed by the ancients as a poison for fish, stupefying them, and rendering it easy to catch them. It is stated that the half-ripe, bruised berries, being formed into little pellets and thrown into the water, are eagerly devoured by the fish, which thereupon are soon seized with dizziness, and, after whirling around, remain motionless, and float on the surface of the water. It is stated that if the fish have eaten any considerable quantity of the Cocculus before succumbing to its influence, their flesh becomes poisonous.
The active poisonous principle of Cocculus is stated to be picrotoxin. Recent toxicological experiments have been made with this substance. It is probable, however, that this does not comprise the entire active principle of the Cocculus, any more than strychnia does that of Nux vomica or quinia of Cinchona.
In consequence of its use as a means of stupe-fying fish, and also as the basis of an infusion for the destruction of pediculi and other vermin, cases of poisoning with it have been recorded from time to time. It has been, and still is, extensively used in Great Britain for the purpose of adulterating malt liquors, it being supposed greatly to increase their intoxicating properties, and also to prevent the secondary fermentation.
Cocculus was first introduced into the materia medica, and used as a remedy in the treatment of diseases, by Hahnemann.
He published, in 1805, in the " Fragmenta de Viribus Medicamentorum Positivis,"—the germ of the "Materia Medica Pura,"—156 symptoms of Cocculus, together with a few observations from other authors.
He had already, in an " Essay on a new Principle for ascertaining the Curative Powers of Drugs," published in Hufeland's "Journal of Practical Medicine," in 1796, stated, on the authority of Amatus Lusitanus, some symptoms produced by Cocculus in the healthy subject, and had used this language: "Our successors will find in Cocculus a very powerful medicine when the morbid phenomena it produces shall be more accurately known."
In "Hufeland's Journal," in 1798, Hahnemann published a case of poisoning, occurring in a healthy man, from a single grain of the Cocculus seed. To this we shall recur at a later period, only stating here that Hahnemann relieved the man with Camphor.
In volume one of the " Materia Medica Pura," Hahnemann published a proving of Cocculus in 1811. Some additional symptoms were contributed by Hartlaub and Trinks, in their " Pure Materia Medica," and Hahnemann incorporated these (with three exceptions) into his own proving in the second edition of the first volume of his " Materia Medica Pura," published in 1830. This last publication we shall make the basis of our study.
In the introduction, Hahnemann says that " Cocculus will be found curative where the symptoms correspond, in certain forms of sneaking, insidious, nervous fevers; in so-called abdominal cramps ; and so-called spasmodic pains of other parts of the body, etc., etc. ; in not a few cases of paralysis of the extremities, and in mental affections." From the publication of this proving to the present day, the records of the Homeopathic Clinique have furnished, from time to time, cases in abundance corroborating these statements; and yet, in 1848 (Canstatt's " Jahresbericht," p. 137), Tschudi announces the discovery that Cocculus " acts chiefly on those parts of the nervous system which control muscular action," and has the impudence to claim as original the suggestion to use picrotoxin " in paralysis of the extremities and of the sphincters;" and Reil, acting on this suggestion, employed a tincture of the seeds of Cocculus, with success, in chorea, in hemiplegia from cold, and in paralysis of the bladder from the same cause. (" Materia Medica der reinen Pflanzenstoffe," p. 220.)
Turning now to Hahnemann's proving of Cocculus, in volume one of the second edition of the "Materia Medica Pura," we proceed to make, in conformity with a schema for the study of the materia medica published in the "American Homeopathic Review," vol. 3, the following
HEAD. SENSORIUM, Vertigo. Cocculus produces a well-marked vertigo, described as like drunkenness. It occurs when sitting up in bed, is a whirling vertigo, is always accompanied by nausea, which, together with the vertigo, compels a resumption of the recumbent position; accompanied by a peculiar dullness in the forehead, as if there were a board in front of the head.
In the condition of circumstance this vertigo resembles that of Bryonia (it occurs when sitting up in bed, and compels a recumbent posture).
INTELLIGENCE. Dullness ; distraction ; difficulty in understanding what is heard or read, and in appreciating the lapse of time; the prover sits as if sunk in thought, not regarding what occurs about him.
MEMORY. Weakened. As a general thing the symptoms of the sensorium are aggravated by any mental effort of any kind.
HEADACHE. Location; chiefly in the forehead and temples; somewhat in the vertex. Pains pass from over the right eye into the head; also, pressing pains extend downward in the whole head; from the temples inward.
Sensation. The chief and controlling sensations are dullness, pressure, compression, constriction ; a headache is also described as compounded of the above sensations, together with digging and boring. There are also stitches in the temples, and in the right frontal region. Hahnemann gives a special prominence to the following symptom: " Headache, as if the eyes would be torn out."
Conditions. These sensations, both the dullness and the pains, and particularly the pressing pain in the head and forehead, occur in the forenoon; are very much aggravated by reading and thinking, and particularly by eating and drinking; also by walking.
The muscles of parts of the head are affected in a manner which we shall see to be characteristic of Cocculus. There is cramp-like pain in the left temporal muscle; pain as if the eyes were forcibly closed ; convulsive trembling of the head.
EYES. Lids. Pressing pain, with inability to open the eyes at night. Dryness.
Globe. Stitches from within outward; feeling as if the eyes were torn out.
Special sense. The pupils are contracted. Muscae volitantes; a black figure seems to float before the eye, moving as the eye moves, yet without impairing vision. Hahnemann emphasizes the symptom "obscured vision."
In the symptoms of the head we perceive no evidence of organic change. The symptoms are such as accompany gastric disturbances and the dyscratic conditions on which continued fever is supposed to depend. No organic changes seem to be produced in the eye; but the symptoms of the special sense point to commencing amaurosis, a paralytic condition of the optic nerve, similar, perhaps, to that produced by Cocculus in the muscular nerves.
EARS. Attacks of deafness, and of noise in the ears like the rushing of water, attended by deafness.
These symptoms have the same significance as those of the head.
NOSE. Increased sensibility to odors.
FACE. The pains are confined to the region of the malar bone and the masseter muscles, where they are pressive and benumbing and cramp-like, increased by opening the jaw. Redness of the cheeks and heat in the face, without thirst. Swelling of the sub-maxillary glands. The features are sometimes distorted.
TEETH. The teeth are long and loose.
MOUTH. Dryness without thirst. The saliva is frothy.
Taste. Coppery, metallic, sour after eating and coughing; bitter taste on the base of the tongue.
TONGUE. Yellow coat upon the tongue. The tongue seems paralyzed, so that speech is difficult; pain at the base of the tongue when stretching the tongue out.
THROAT. Externally. Stiffness of the cervical muscles. Paralytic drawing of the sides of the throat. The muscles seem weak and the head heavy ; he must support the head; is most relieved by leaning it back.
Internally. Dryness and roughness, especially when swallowing. Dryness high in the fauces. Burning in the palate. Sensation of swelling at the root of the tongue. A feeling of constriction in the fauces which impedes respiration. A kind of paralysis, preventing swallowing.
The above symptoms point to no organic changes, but indicate rather a kind of paralysis of isolated groups of muscles, E. G., the sterno-cleido-mastoid, the constrictors of the pharynx, the lingual.
STOMACH. In the epigastrium, over the stomach and extending to the hypochondria and into the chest, a pressing, pinching, constricting, cramp-like pain, which takes away the breath ; occurs and is worse after eating and drinking; also when walking; is worse from cold ; is accompanied by nausea.
Appetite. Loss of appetite; disgust for food, the very smell of which is offensive ; at the same time a sensation of hunger at the epigastrium; aversion to acids; bread tastes sour.
Thirst. Aversion to drinking, and yet great thirst.
Nausea. Great nausea is a characteristic symptom of Cocculus. It is provoked by eating, drinking, by motion, by becoming cold, especially by driving in a wagon; by sudden change of posture. It occurs in connection with the headache and the pains in the intestines.
Eructations. Bitter, putrid, causing sore pain in the epigastrium and chest. Incomplete eructation, hiccough and spasmodic yawning.
The attacks of nausea sometimes produce fainting.
ABDOMEN. Pressure ; sticking and cutting pains in various parts of the abdomen, chiefly around the navel. Feeling of emptiness in the abdomen.
FLATUS. Rumbling in the abdomen; great distention ; incarceration of flatus ; severe flatulent colic at night.
HYPOGASTRIUM. Constricting pain, with pressure toward the genitals, and qualmishness in the epigastrium. Disposition to inguinal hernia, with pain and soreness. Rupture-pain worse on the right side; fullness in the groin, with a sensation as if all would give way there. (Singular and characteristic symptoms.)
STOOL. Constipation. Stool followed by violent tenesmus in the rectum, producing faintness, also diarrhoea; small frequent stools, each accompanied by flatus.
RECTUM. Disposition to stool, but th'e peristaltic motion in the upper intestines is wanting.
URINARY ORGANS. Frequent discharge of watery urine.
GENITAL ORGANS. Sore and sticking pains in the testes. Itching of the scrotum. Alternate excitement and depression, the former being probably the primary action. Menses suppressed. Menstruation difficult, attended with violent spasmodic pain in the abdomen and loins, increased by motion, cold and contact.
RESPIRATORY ORGANS. Dyspnoea, as if from constriction of the larynx. Sneezing, coryza, disposition to cough, from an irritation high up in the larynx ; from constriction of the chest. The cough is increased by indulging the disposition to cough, as is the case with the cough of Ignatia. Fine stitches in various parts of the chest; feeling of emptiness in the chest; palpitation and anxiety.
In the above symptoms no local organic affection is evident. They may all be ascribed to an affection of the spinal marrow or nerves (functional or organic).
BACK. Spasmodic constriction through the whole length of the spine, especially on motion.
SACRUM. Paralytic pain extending over the hips, interfering with walking, along with an anxious, apprehensive disposition.
LOINS. Paralytic pressure, tearing, drawing as if broken, as if stiff. All these pains are increased by motion and by cold.
UPPER EXTREMITIES. Paralysis of the hand when writing. Pains in the bones, as if bruised ; in the arms, felt on lifting the arms. The arms go to sleep. Hot swelling of the hands.
LOWER EXTREMITIES. Paralytic immobility, extending from the sacrum. Sore pain of the thigh. Inflammation and swelling of the knee (?). Burning in the feet.
SLEEP. Coma. Coma vigil. Absence of sleep from anxiety and bodily restlessness. Anxious dreams.
FEVER. No definite typical fever. Constant chilliness, while yet the skin is hot. In the evening chills run down the back. Exhausting sweat during motion.
DISPOSITION. Mild, indolent, despondent in the face of difficulties, excessive anxiety, fearfulness; intolerance of noise or any disturbing influence.
VITAL POWER. Cocculus exercises what may be called a purely depressing action upon the vital power. This action is called pure because it is not, so far as we know, dependent upon any change in the organic substance. Thus the sensorium is benumbed, as the marked vertigo and confusion show. Of the special senses, that of vision is so distinctly impaired as to remind one of incipient amaurosis ; but the most marked action of this character is exhibited in the voluntary muscular system, paralysis more or less complete being produced in the eyelids and in the muscles of the face, the tongue, the pharynx, and of the extremities, particularly of the lower extremities; of this nature, perhaps, are the symptoms of the inguina, resembling hernia.
ORGANIC SUBSTANCE. While the action upon the vital power is, as has been seen, very marked and definite, that upon the organic substance is scarcely perceptible. The circulation is but little affected. The evacuation is scarcely altered, though, as might be expected from the depression produced in the general vital power, the secretion from the surface of the intestine is diminished. Eruptions are mentioned in the proving, but in so indefinite and isolated a way that we can hardly attach to them any physiological significance.
SPHERE OF ACTION. Pre-eminently the system of animal life. The vegetative system is hardly affected at all. The voluntary muscular system first, and then the sensorium, are the primary seats of action. In addition to the above, and not evidently connected with it, must be mentioned the action of Cocculus upon the stomach and digestion. Nausea, extending to the point of vomiting, and accompanied by faintness and by severe vertigo when lifting the head, is a characteristic symptom. The nausea is felt from the epigastrium to the throat. It is accompanied by a sensation of constriction around the waist, is aggravated by eating, drinking, by motion, by mental exertion, and in the open air. The taste is bitter and metallic.
The appetite is completely wanting.
SENSATIONS. A general sensation of lassitude, which makes the least exertion, even standing, very irksome. Syncope often follows any bodily exertion. In the extremities, drawing and digging pains in the bones, but more frequently a weakness as if paralyzed. Sometimes this sensation is accompanied by twitchings of isolated groups of muscles.
PERIODICITY. Not at all marked in Cocculus.
PECULIARITIES. The symptoms of Cocculus in general, and particularly those of the head, are aggravated by eating, drinking, any bodily or mental exertion, by tobacco smoke, and by cold air. They are accompanied by a great intolerance of fresh air; in fact, all the functions of animal life seem to be more or less torpid, and intolerant of any stimulus. There is a constant disposition to sleep, and yet the sleep is restless, interrupted by frequent wakings and startings, so that in the morning one is still sleepy. As regards the disposition, the prover seems sunk in deep thought of an unpleasant and rather sad character. Nevertheless he is easily roused to anger.
In many respects Cocculus reminds one of Pulsatilla, which also depresses the vital power, but the symptoms of Pulsatilla are ameliorated by cold and by motion, and the disposition of Pulsatilla is gentle and yielding. In its action upon the digestive organs, Cocculus resembles Nux vomica; the characteristics, particularly the conditions of aggravation, distinguish them. Moreover, Nux vomica affects the vegetative system quite as much as the animal. Cocculus resembles Ignatia somewhat in the almost simultaneous appearance of seemingly incongruous symptoms. It is probable that we shall find a closer analogy to Cocculus in Tobacco than in any other remedy.
Hahnemann recommends Cocculus in certain kinds of insidious, nervous fevers. In this Hartmann agrees with him, and says: "Particularly in cases which have been produced by frequent fits of anger, or are accompanied by great disposition to anger." Hahnemann recommends it also in several kinds of spasm, as, for example, in menstrual colic, resulting from sudden suppression, or hindered coming on of the menses; in spasmodic flatulent colic. Its chief application, perhaps, is in the treatment of paralysis of the extremities, particularly in hemiplegia. Cocculus has proved a very valuable remedy in sea-sickness; and has cured many persons of a tendency to nausea and faintness from riding in a wagon. Dr. Curie has found Cocculus a valuable remedy, along with Nux vomica and Antimonium crudum, in the various forms of dyspepsia from over eating and drinking, which are common among a certain class of the English people.
The following remarks by Dr. Wurmb ("Clinische Studien," 1, Typhus, p. 124) give a clear picture of that kind of slow nervous fever to which Cocculus is adapted:
After dividing typhus into several groups, in all of which the systems of vegetable and animal life are affected to an equal extent, he says that other cases occur which may be divided into two groups. " In the one, the system of vegetable life is profoundly involved, while the animal life is scarcely at all affected. For this group Veratrum is the chief remedy. In the other, the animal life is pre-eminently involved ; vegetation is hardly affected. For this group Cocculus is appropriate." He says: "The patients complain at first of lassitude, prostration after the slightest exertion, difficulty in thinking, loss of memory, loss of appetite, and invincible disposition to sleep. They soon feel so weak that they must keep the bed, and they fall into an apathetic condition, which ends in actual coma. If awakened out of this, they complain of vertigo, of a feeling as if a heavy load were pressing upon the head, of weakness, and a paralyzed feeling in the limbs, but especially in the eyelids, which they can hardly keep open. Sometimes, instead of the paralyzed feeling, there is a sensation of twitching and jerking. The patients think correctly but slowly. They soon fall back into the comatose condition; the expression of countenance is devoid of all signs of mental activity. This condition is not uninterrupted; for there occur sometimes intervals of moderate excitement, during which the patients, awakened from their stupor, look eagerly around, move themselves quickly, and, by the hastiness of their replies, seem to seek to hide their lack of force; sometimes there is mild, uneasy delirium.
"In this torpid condition of the nervous functions the rest of the organism participates but little. The pulse is weaker, it is true, but seldom sinks below the average frequency, often even rises above it. The temperature remains normal or changes but little; the skin is pale but lax; the tongue moderately coated, sometimes even clean ; the bowels generally constipated, diarrhoea rarely present; the respiratory mucous membrane almost never involved.
"Symptoms of a blood dyscrasia, such as exanthemata, decubitus, haemorrhages, are never observed. The spleen is always swollen."
Among the applications of Cocculus must not be forgotten its use in inguinal and femoral hernia, of which several cases are recorded as cured by Cocculus ; among them one in which four herniae existed simultaneously. Precisely what cases are curable by Cocculus it is not easy to say A PRIORI. Other remedies, as, for example, Nux vomica, Aurum and Nux moschata, have also cured hernia. Until the functional pathology of hernia shall be better understood, it will be impossible to divide the affection into groups corresponding to the different modes of treatment, or different remedies which experience has shown to be useful. While the affection is, by most practitioners, regarded as exclusively a mechanical accident, to be met by surgical methods, the history of many cases and experience in their cure, shows them to be amenable to dynamic agencies.
In all of these applications, as in others which may be made of Cocculus to the treatment of diseased conditions, the similarity of the symptoms must be our only sufficient guide.