SQUIRTING CUCUMBER : BITTER APPLE.
We use in medicine the pulp of the fruit, an exceedingly bitter and nauseous production.
It was known to the early Greeks, and a great regard for its medicinal virtues is expressed by all the ancient writers. Among moderns it has fallen into disuse and some discredit, except as an ingredient of the officinal and other compound cathartic pills.
It was classed as a drastic or as a hydragogue cathartic along with scammony and gamboge. And in modern times, under the sway of the physiological school, which denied to drugs the possession of any individual specific properties peculiar to each, according them only certain general properties which were common to them and other members of a group, it was thought that for Colocynth might be advantageously substituted some less powerful, perhaps, and less distressing, purgative. But we shall see that Colocynth has certain properties which no other drug possesses.
I may remark, in passing, that it seems remarkable that physicians who dreaded the too powerful action of Colocynth, should yet so often,—in seeking to blend with it a drug or a complex of drugs which should moderate and correct its vigorous action,—have selected for this purpose other powerful drastic cathartics, such as scammony, gamboge, veratrum, black hellebore, etc. Nay, Dodonaeus even says that violent purges are the best corrigenda of Colocynth. It can hardly be but that, under the law "SIMILIA SIMILIBUS CURANTUR," these violent drugs, to a great extent, neutralize and antidote each other. Of the fact of this neutralizing effect there can be no question. It is universally admitted. Why may it not be accounted for by the same law which accounts for the subsidence of morbid symptoms through the action of the similar remedy?
But what a discovery was that of Hahnemann, so laughably simple, yet so unsuspected, that the too powerful action of a drug may be moderated by just diminishing the dose, and by going on to diminish it until the dose acts as gently as you wish.
Another Columbus with another EGG !
The action of Colocynth in large doses is shown forth by the following cases:
A woman, aged forty years, had a chronic rheumatic pain in the left thigh and left shoulder. A kind friend advised her to infuse half a pound of Colocynth in a half pint of red wine, and to drink the fluid before going to bed. By good fortune she took only one-half part of the infusion. Scarcely had she swallowed this, when she was seized with fearful pains in the region of the stomach, great anxiety, vertigo, faintness and cramps. She vomited several times without relief; then evacuated copious stools, at first watery and feculent, then consisting of pure blood, with distressing tenesmus; along with these came large pieces of the inner membrane of the intestine. The pain then concentrated in the stomach and in the lower part of the rectum; the abdomen became collapsed; at last the tenesmus ceased, and the patient gradually fell asleep. Great exhaustion followed, but she finally recovered.
In another case of the kind, which proved fatal, the autopsy revealed that the intestines were red, with black spots, glued together by false membrane. A white fluid had exuded into the cavity of the abdomen, and in it white flocculi were floating. On the coat of the stomach here and there an ulcerated spot could be seen. There was no trace of inflammation in liver, kidney or bladder.
Hahnemann and six of his pupils proved Colocynth, but the result was quite meagre. It was reserved for the Austrian Proving Society to show us a full picture of the pathogenesis of this drug.
These provings, viewed collectively, show us, what indeed we knew before, that the effect of Colocynth upon the alimentary canal is immediate and profound, that it produces vomiting and purging of watery matters, and then of mucus and blood; great flatulent distention of the abdomen ; and cruel, griping, flatulent colic. They give finer shades of delineation, however, than cases of poisoning could.
Furthermore, they reveal to us an action of Colocynth that was heretofore masked under its violent action on the alimentary canal. I mean its power to produce neuralgia, affecting: I, the trifacial nerve; 2, the solar plexus; 3, the lumbar and femoral nerves and their branches. Yet this knowledge has enabled us to effect some most brilliant cures, and to grope our way toward others, which could never be clearly indicated by any proving. Furthermore, a power to affect the ovaries is shadowed in the proving of Colocynth.
Upon the mind Colocynth exerts no deep action. It produces impatience, vexation, excitement, followed of course by prostration and dejection.
SENSORIUM. Dullness of the head, vertigo, confusion.
Violent headache, as if brought on by exposure to a current of air. Aching pain along the sagittal suture, increased by exercise and by stooping.
Pressing and drawing pain in the left side of the forehead. Drawing in the forehead as if it would be pressed out. Digging in the left temple. Pulsation in the left temple, which afterward changes to lancinations, the same being felt simultaneously in the left shoulder.
Tearing and tension in the left side of the face, extending to the ear and head. Cramp-like sensation in the left malar bone, extending into the left eye. Feeling of pressure in the orbits near the root of the nose, with confusion in the head and chilliness.
Scraping and burning in the mouth and throat. Eructations. Nausea. Vomiting of food and vomiting of greenish fluid. Vomiting with diarrhoea.
Pain in the stomach after eating. Fullness in the epigastrium. Squeezing and wringing pain in the stomach.
Colic and diarrhoea after taking the least nourishment.
Flying pains in the hepatic region.
Constricting pain in the centre of the abdomen, recurring at short intervals, and passing into a sharp griping.
Griping in the abdomen, especially about the umbilicus, like a cutting or squeezing; relieved by bending forward or on evacuating the bowels.
Pain in the whole abdomen, as if the bowels were squeezed between stones.
Rumbling and commotion in the hypogastrium.
The colic comes on every fifteen or twenty minutes, and is relieved by pressure and by bending forward.
Diarrhoea, with nausea. Stool semi-liquid, brownish yellow, retained with difficulty; preceded by colic; some tenesmus. Liquid frothy stool ; saffron yellow, and of a musty odor; watery-mucous and bloody stools. Sensation of weakness in the rectum.
Abundant urine. Frequent desire to pass water, with burning in the bladder and stitches in the bladder; alternating with stitches in the rectum.
Menses early and more abundant.
Under Dr. Frohlich, Colocynth was proved by two young women, who both experienced, beside the symptoms of the abdomen and bowels, deep stitches in the ovaries on both sides, but worse on the left.
The respiratory organs are not markedly affected.
Drawing, lancinating pain in the left shoulder, extending thither from the left side of the face over the neck. Drawing pain and stiffness in the muscles of the left side of the neck. Generally this pain is relieved by motion.
In the upper part of the nape of the neck, close to the occiput, a sensation as if a heavy weight were there. Rawness in the right scapula, a feeling as if the nerves and blood-vessels were stretched. Severe contusive pain from the right side of the neck down to the scapula.
(It is to be remarked that with all these symptoms there is no fever, no sensitiveness, no heat; motion generally relieves.)
Drawing and paralytic pain in the arms.
The lower limbs are weak and heavy.
Tension in the right groin. Pressure at the left sacro-iliac articulation, with tingling at the sole of the foot.
Drawing in the right thigh down to the knee. Pain darting from the tuber ischii to the knee. Drawing, darting and obscure pulsation in the left hip. Tingling in the left foot, with simultaneous pressure about the sacro-iliac articulation. Pulsation in the left gluteal region. Drawing in the right thigh down to the knee.
Only during motion pain in the right thigh, as if the psoas muscle were too short; better on ceasing to walk; recurring on moving again.
Cramp-like drawing in the internal femoral region. Stiffness of the knee, as if bound around with a cord.
Tearing, drawing and pressure throughout the limb.
Dr. Watzke of Vienna says:
The hemicraniae and prosopalgias which Colocynth will cure, are, in all cases, purely functional derangements of the filaments of the trifacial nerve.
In the prosopalgias of Colocynth there are no twitchings of the muscles, nor any palsied feelings in the affected side; the pain follows the course of the nerve, is periodical, and accompanied by toothache." Colocynth is related to Belladonna, Capsicum and Verbascum.
Colocynth is adapted to what Romberg describes as neuralgia hypogastrica, and which is often described and regarded in women as menstrual colic; and in men as haemorrhoidal colic; attended by pains and aching in the thighs.
The intestinal affection indicating Colocynth is hardly inflammatory (and yet the autopsy shows it).
The ischialgia; are not due to strumous diathesis or to organic changes.
And yet unless many skillful physicians have been greatly deceived, Colocynth has arrested and cured, in its early stages, morbus coxarius.
It is not easy nor safe to undertake to distinguish, in early stages, functional and organic affections, and to set apart remedies for the one and for the other on pathological grounds. Experience gives the lie to our hypothesis.
The presumptive action of Colocynth on the ovaries deserves attention and experimental research.