Editorial Note: Dr.Deweys Lectures in Materia Medica have been made available for publication during the past year through the courtesy of Dr.Garth Boericke of Philadelphia. A part has been published in the Journal of the American Institute of Homoeopathy as follows:.
August 1930. The Ranunculaceae, including Aconitum, napellus, Staphisagria, Actea Spicata, Hydrastis, Helleborus niger and Clematis erecta.
September 1930. The Ranunculaceae, continued, including Ranunculus bulbosus, Ranunculus scleratus, Pulsatilla and Cimicifuga. The Solanaceae, including Belladonna.
November 1930. The Solanaceae, continued, including Belladonna (continued and Hyoscyamus.
December 1930. The Solanaceae, continued, including Stramonium, Dulcamara, Tabacum., Capsicum annum. The apocynaceae, including Nux vomica and Strychnia.
February 1931. The Apocynaceae, continued, included Nux vomica (continued).
July 1931. The Apocynaceae, continued, including Nux vomica (continued), Ignatia, Gelsemium, Apocyanum cannabium, Oleander, Vinca minor and Spigelia. Curare and Alstonis scholaris were omitted and will be printed in l latter issue of the Recorder.
Through the courtesy of Dr.Linn. J. Boyd, Editor-in-Chief of the Journal of the A.I.H., the larger part of the Dewey notes, as yet unpublished, have been obtained for publication in the Recorder. This series will run over many months. It is hoped that eventually we may be able to publish the whole series complete in book form for these lectures, with their rather full comparisons are of great practical value.- E.B.L.
THE CUCURBITACEAE FAMILY.
BRYONIA, ALBA, COLOCYNTHIS, ELATERIUM, MOMORDICA BALSAM.
The principal drugs of this family are Bryonia and Colocynth. We also have two or three others, for instance, Elaterium and Momordica balsa.
We have several edible substances from the same family, watermelon, squash, muskmelon and cucumber.
Drugs of this family act prominently on the alimentary tract and the first one which we shall consider is one of the principal, oldest and best proved remedies of our materia medica. It is the.
The Bryonia grows in Europe along hedge-rows and fences. It is the white Bryony or wild hops. There is a variety which grows in England called the Bryonia dioica whose action is apparently the same as the alba. Our tincture is prepared from the fresh root and vine.
Bryonia was proved by Hahnemann and his pupils. One of the few clinical cases left us by Hahnemann was a cure by Bryonia. He remarks that the symptoms it excites in the healthy correspond to many affections of daily occurrence and that hence its healing power must be of wide range. And so it is. It is one of our great polychrests. It was also proved by the Austrian society and Allen records some 2,000 symptoms attributed to the drug. In Austria the peasants take the root, excavate it and, filling the cavity with wine or beer, it as a purgative.
GENERAL ACTION. The action of Bryonia is clearly defined and interesting. We infer from its symptoms that it acts especially on the serous membranes and the viscera they enclose, especially the pleura and lungs, then the peritoneum, and , as here the liver is enfolded, we find this organ also affected by Bryonia. Again, the arachnoid membranes, also a serous membrane enfolding the brain, is affected by Bryonia. Bryonia sets up an inflammation in these serous membranes, not like Aconite, with a fever of sharp, well pronounced synochal character, but more sub- acute, a fever of fever of rather a low type, one that comes on after Aconite, when the inflammation has gone on to the stage of serous exudation. This is, them, the place for Bryonia. Have you to treat a case of pleurisy or pericarditis or peritonitis? Has the inflammation localized itself in these parts? Is there exudation? Bryonia is your remedy. It will remove the still existing local inflammation and absorb the serous effusion. Again the synovial membranes are inflamed and the muscular fibre irritated, this gives a close picture of true articular and muscular rheumatism. Bryonia is one of our mainstays in the treatment of serous inflammations, in disease of the lungs, liver and alimentary tract, and above all in the treatment of fevers.
GRAND CHARACTERISTICS. #
1. Apathy, all pervading, ranging from languor to torpor. There is great disinclination to make any effort.
2. Sharp, stitching pains. You will find these in the head, face, teeth, throat, liver, abdomen and extremities, but especially in the chest.
3. Relief of all conditions by rest, and aggravation by motion. The patient cannot sit up, it makes him sick and faint. He finds relief by lying on the painful side. Why? It prevents motion of the parts, it rests the parts, and he prefers to be quiet and not move about because every part of his body is painful to pressure and motion. This great characteristic of Bryonia you will find in children. They slow to by their dislike to be carried or raised up, it hurts them.
4. Relief of all conditions, except the headaches, by external warmth. There are some eye symptoms which are also not relieved by warmth but his general relief is a characteristic of the remedy.
5. The seat of any distress or irritation is very apt to grow sore and tender to the touch.
6. Dryness of the mucous membranes. The patient complains of dry mouth, dry throat, dry cough, no secretion, scant secretion of gastric juice, a comparative dryness. The same condition is found in the intestines, hence, dry stools difficult to expect.
ENVIRONMENT. Bryonia is more suitable to robust than to weak person,s such as are accustomed to rich living with rich blood, firm and resisting flesh. The fleshy fibre, in other words, the solid element prevails over the adipose in constitutions especially adapted to Bryonia. Dark complexioned. All circumstances that excite the circulation will produce phenomena similar to those of Bryonia, such as vexation, anger, excessive exertions, (diseases of muscles and joints), changes in weather, complaint when warm weather sets in after cold days. Likewise, whatever occasions an obstruction of a venous character, a sedentary mode of life (plethora). These exciting elements invite the best action of Bryonia. Given these, you will find its symptoms acting mostly upon the right side, here they are the most violent, and here their first effect occurs. Symptoms are generally worse by motion, in the evening at twilight, about 3 a.m., and after rising from bed. Most of the complaints increase in a cold air.
They are all better from quiet, lying on the painful side and being generally passive. There is faintness on rising from bed, worse in the forenoon and while walking, so that he drags himself about with weakness in the knees and legs on ascending stairs.
GENERAL ANALYSIS OF BRYONIA.
MENTAL. The Bryonia patient is usually of an irritable temper, everything puts him out of humor. Remember that it acts best in dark haired bilious subjects. This moroseness is like that of Nux, only in Nux the patient is ugly most of the time, while Bryonia is good natured except when disturbed.
HEAD. The Bryonia headache is chiefly gastric, rarely neuralgic. It is characterized by vertigo worse rising, heaviness, pressure and soreness. Headaches are often occipital, going from the forehead back to the occiput. Headache commences in the morning when first opening the eyes. The headaches are all aggravated by any motion, even of the eye balls, and by exertion. Rheumatic headaches such as would result from bathing head after perspiring. In such cases opening the eyelids increases the pain. There is drawing in the bones toward the zygoma and tearing pains down the face, temples, neck and arms. Headache from ironing. The ache is also characterized as “splitting,” and it is somewhat ameliorated had lasted for a time the scalp becomes sensitive to touch. As a rule light and noise do not aggravate as in Belladonna.
Gelsemium also has a headache with soreness of the eyes on moving them.
Spigelia has pains darting from behind forward through the left eyeball.
Silicea has pain coming up from the nape of the neck through the occiput over vertex and so down on the forehead.
Carbo veg. has dull, heavy pain extending through the base to the brain from the occiput to the supra-orbital region.
Remember that all the symptoms of the head are worse from motion and exertion.
Natrum mur. has a headache as from little hammers, worse moving head and eyes.
Petroleum has a throbbing occipital headache.
Juglans cathartica has an occipital headache with sharp pain.
On the external head Bryonia develops an oily, greasy perspiration making the hair only, something it has a sour smell from over activity of the sebaceous glands.
EYES. Bryonia may be thought of in rheumatism of the eyes with violent pains shooting through the eyeball into the back of the head or up toward the vertex, worse by moving the eyes. It may be found useful in the disease known as glaucoma. There is increased tension of the eyeballs, lachrymation and photophobia. Eyeballs sore.
NOSE. Many of the provers experienced bleeding from the nose, worse mornings, nosebleed after suppression of the menses. The remedy is useful in vicarious menstruation taking on this form.
MOUTH AND TEETH. The lips are often dry and cracked and the patient moistens them frequently. The toothache of Bryonia is of gastric origin or of rheumatic origin and comes from cold. It may occur in sound teeth, the whole of the tooth aches. When we presume that the nerves or dentine in the tooth are inflamed, pressure of the hand, or resting the head firmly against a pillow, may believe. Cold applications believe momentarily.
Coffea. Toothache in children from indiscretions in diet, candy or from constitutional causes relieved by cold water.
Merc. sol. Toothaches traceable to inflamed of dentine.
Kreosote. Neuralgia of the face with burning pains, worse from motion, in nervous, irritable people whose teeth decay rapidly.
In aphthous sore mouth of children when the mouth is dry and the child cannot nurse until it is moistened, Bryonia may be the remedy.
GASTRIC SYMPTOMS. We have seen that the headache is generally associated with gastric symptoms. What are they? Remember the dryness of the mucous membranes, dry mouth. scanty secretion of gastric juice, hence food lies heavy and undigested.
There is in consequence a pressure as of a stone in the stomach, the epigastric region is painful to touch and pressure. Bitter taste in the mouth. This and dryness create an intense thirst, large quantities of cold water are craved.
This pressure in the stomach is more frequent in women. It is cause by irregularity of diet or indigestible food and is present whether the stomach is full or empty. It goes off with eructations. Waterbrash, acidity, heartburn and vomiting of sour and acrid mucus may be present.
It is an extremely valuable remedy for catarrhal inflammation of the stomach with thirst, white coated tongue, nausea and vomiting worse from warm drinks which are vomited, and a feeling of a hard lump with makes the stomach sore.
Sometimes you will have patients who have taken much Mercury. The attacks are frequently preceded by great hunger and are apparently caused by over-eating. In all gastric derangements there is usually great sensitiveness of epigastrium to touch and vomiting of food.
STOOLS. Constipation usually accompanies the gastric symptoms. The fauces are dry, as if burnt, hard and large. Children frequently require Bryonia when the stools are large, hard and cause pain in passing. The liver is affected, congested, with pain in right shoulder, giddiness, yellow skin and eyes, bitter taste, tensive, burning pain in the region of the liver and stitches on pressure, with coughing on deep inspiration. The liver seems swollen, sensitive and sore to touch, Bryonia diminishes the action of the intestines, Nux does not, Nux rather increases it but at the same time renders it inharmonious and spasmodic, a hindrance therefore to evacuation. Hence Nux has frequent, ineffectual desire for stool, the action of the intestine being irregular and spasmodic. Bryonia has no desire for stool, which is just like Veratrum.
Besides the constipation, Bryonia also produces a diarrhoea, preceded by colic, especially at night or early morning, on moving about. In summer or dry, hot weather diarrhoeas. Diarrhoea from vegetable food, stewed fruit, cold drinks or from sudden changes in temperature from being overheated. Diarrhoea from suppressed eruptions.
It is a frequently indicated remedy in cases of typhlitis, appendicitis, peritonitis and gastro-enteritis which are characterized by extreme soreness, thirst, fever, coated tongue and sharp, stitching pains. Jaundice from duodenal catarrh, caused by anger, calls for Bryonia. Although the patient is hot he complains of feeling chilly.
Chelidonium, you remember, has sharp pains in the region of the liver, shooting in all directions, under the scapula, etc., but it is has a diarrhoea of clay colored stools and this decides between it and Bryonia.
It is a useful remedy for the so-called bilious attacks. it has also stitches in the spleen.
URINE. The urine is dark, brown-red without any deposit.
FEMALE. Suppression of menses with the characteristic gastric derangements, or with periodical discharge of blood else where, nose, throat, etc. It is an important remedy in pelvic peritonitis with the sharp, stitching pains. The menstrual suppression may be accompanied with the splitting headache so characteristic of the remedy. This may also occur with suppressed lochia, when the head seems to burst. Inflammation of the breasts. They are hard, tender, hot and have sharp, stitching pains in them. Patient wants to lie absolutely quiet. It is our sheet anchor in milk fever when there is chilliness, fever, headache, coated tongue, aching in the limbs and tender breasts.
RESPIRATORY. Bryonia is indicated in nasal catarrh when the discharge from the nose is thick and yellow. Here, you see, it is not a beginning remedy but comes in rather late. It is also useful when the catarrh is suppressed and you have maddening headache at the root of the nose, at every step it seems as though a knife had gone through the head. Bryonia affects chiefly the trachea and it is useful in tracheitis when the inflammation does not extend lower than the first division of the bronchi. The cough has little expectoration, it is dry, continuous, irritating, violent, often causing retching and pains in the walls of the chest. There is heat, soreness and pain behind the sternum. The patient often presses on sternum to support the chest during the cough. Hoarseness, tough mucus, loosened only after frequent hacking.
The patient coughs until the seat of the irritation becomes sore. Sometimes the cough seems to come from the pit of the stomach, worse coming into a warm room from the cold air. The patient coughs until that spot becomes sore, even to pressure. When the cough comes on the patient must sit up.
In pneumonia, proper croupous pneumonia, Bryonia is often indicated after Aconite, Veratrum viride of Ferrum phos. The fever still continues but he disease has become localized, as seen by the oppression, anxiety, and pulmonary oppression, referable y to the chest. You have a fibrinous exudation in the air cells to which Bryonia corresponds. The general symptoms already given will indicate it more particularly. Stitching pains, because the pleura is involved, worse from the slightest motion, deep inspiration, coughing or moving. Lies perfectly still in consequences. the expectoration is especially scanty and sometimes it is absent, or it may even be the scanty rust-colored expectoration so characteristic of the disease. It is always indicated after Aconite, the fever continues but the skin is not so hot, the face is not so red, and the patient is not so restless as when Aconite was indicated. Aconite pictures an expression of pulmonary oppression.
Iodines is one of the first drugs in the list for pneumonia. It has high fever, restlessness and a tendency to a rapid extension of the hepatization. It seems to limit the spread of the hepatization.
Bryonia has great affinity for the chest and its organs, especially for the intercostal muscles and pleurae. Pleurodynia, stitch in the side, pleurisy. Here you will have symptoms of tightness of breathing, pressure, and the physical signs. Bryonia products the most terrible shortness of breath, worse from the least movement.
In stitching pains remember Ranunculus bulbosus, which has sharp pains following the course of the intercostal nerves, but not especially aggravated by a deep breath.
Phosphorus either follows Bryonia in pneumonia or is the remedy from the start, when the sharp pleuritic pains are absent, in tall spare built subjects.
A typhoid condition may be present, tongue dry, dark-brown, great pain and oppression of chest. Cough with bloody difficult expectoration. Severe asthenic cases.
Senega is adapted to sluggish cases which do not get over a cold, sore spots in the chest remain after a cold, hoarseness, cough ends in a sneeze, much mucus in the chest. Useful in irritative, shaking cough of old people.
Chelidonium resembles Bryonia in its action upon the liver and in pneumonia. It is preferable when the patient is a blonde and of a placid temperament. Right-sided pneumonia with involvement of the liver. There is a pain at the lower angle of the right scapula running into the chest, jaundice, and much mucous expectoration. Bryonia has scanty expectoration.
Asclepias tuberosa is useful in very heavy colds with loose, violent cough and sharp, stitching pains in the chest. The cough is looser than the Bryonia cough and the patient is more generally “broken up” with the cold.
Kali carb. has stitching, worse by rest, lying on the affected side, and around 3 a.m.
FEVERS. The fever of Bryonia is not marked by the violence, acuteness and general storm of Aconite, nor by the decompensation and the great debility of the acids. It is neither synochal nor so markedly upon local affections, the state of stomach, liver, chest, etc. Inflammations of the brain, stomach, respiratory organs, cellulitis, etc., where the fever depends upon the local lesions, are met by Bryonia. When the general storm which at first swept the system has localized itself somewhere, then Bryonia comes to your aid.
The Bryonia fever is especially suitable to two great types, the rheumatic and the typhoid. The fever is marked by gastrohepatic complications, such as the coated tongue, the foul and bitter taste, nausea, vomiting, soreness, tension and stitches in the hypochondria, together with dizziness, faintness on sitting up and the splitting headache through the temples and in the occiput, weakness, fatigue from the least exertion and inclination to absolute rest and quiet. Pains are worse on moving the affected parts.
The pulse is tense, hard and frequent. Cold and chilliness predominate. If it is a case of typhoid fever you will have more dizziness, nosebleed at 3 a.m., dreams of the business of the day, delirium-thinks he is away from home and wants to run away. The provers of Bryonia complained much of general and internal oppression of the brain, indicating affections of a serious character. The giddiness, the suspension of the thinking faculty, the confusion, the vanishing thoughts, the dull pains point to just such involvement of the sensorium. Beginning blood deterioration and blood poisonings, such as are usual in organic disease, in typhoid, in milk fever congestions, in pyaemia and in other nervous conditions due to the absorption of irritating matter into the blood offer a great filed for the action of Bryonia. The fever of Bryonia resembles that of Baptisia and Eupatorium,but Baptisia has more of a besotted look, fetor more marked, more evidence of disorganization of the blood, sordes, putrid ulceration, prostration, feel himself in pieces, sordes, putrid ulceration, prostration, feel himself in pieces, while Eupatorium has more marked bone pains, intense aching in limbs as if bones were broken. The Eupatorium sweat is scanty or wanting, that of Bryonia profuse.
As the disease advances Bryonia may still be indicated, provided there is not diarrhoea, but when this occurs Bryonia will probably give place to some other drug. In addition to these symptoms the patient becomes exceedingly irritable and loses strength very rapidly, is hasty in his manner, speaks hastily, eats and drinks as if he were in a hurry and has also a nervous quaking.
In the rheumatic fever Bryonia follows Aconite. Remember the stitching, tearing pains, the affected parts soon become red, a shiny redness, swollen and sore, worse from the slightest motion. Effusion into synovial sacs follows with great tension and exquisite sensitiveness to touch. Affected parts are hot, tense and swollen. Bryonia is especially indicated when the synovial membranes of the joints are the seat of the inflammation rather than the tendons, fascia and ligaments around them. There is more local swelling and less general fever and the pains worse morning and evening are relieved by warmth.
BACK AND EXTREMITIES. Besides the above uses in rheumatic fever it is useful in cases of rheumatic pain in particular muscles after cold drafts, when there is tensive, painful stiffness. Lumbago or muscular rheumatism in the large muscles of the back, the quiet type, with great aggravation on moving.
Rhus. Lumbago with stiff strained feeling. The patient is aggravated on first rising or moving off, obtains relief from continued motion and is worse from damp or cold weather. Strains, over-exertion of the back. Rhus attacks the fibrous tissues of the sheaths of the muscles while Bryonia attacks the muscular tissue itself.
Rhododendron. Lumbago worse before a storm, immediate and continued relief from motion.
Colchicum. Dark red swellings, tearing pains as if in the periosteum, superficial in summer, deeper in winter. The Colchicum patient is weak and has general vital atony. Hence it is particularly suited to the debilitated. The stomach is generally affected, nausea, cannot bear the smell of the food.
Bryonia is rarely yet sometimes indicated in gout.
Ledum. This remedy has a rheumatic or gouty inflammation of the great toe joint with scanty effusion, hardening into nodosities. In hot swelling of the hip and shoulder Ledum is to be preferred to Bryonia.
SKIN. The Bryonia skin is yellow, we would expect that from its action on the hepatic system, its biliousness, its jaundiced look and mood. Itching may accompany. It is pale and swollen as in dropsy. It is hot and painful to the touch. Again, it has nodules and vesicles, bullae which open and leave a raw surface exuding an ichorous fluid. Erysipelatous inflammation especially of the joints. Slow development of rash is tardy in making its appearance, with the hard, severe cough or the rash runs as irregular or balky course or disappears and cerebral symptoms develop. The child becomes drowsy, the face is pale, twitching. Any motion causes the child to scream with pain, In such cases bryonia is the remedy. It may also be indicated in scarlet fever which does not run a smooth course but is interspersed with miliary rash, the rash comes out imperfectly and chest symptoms develop.
Cuprum is the remedy when the eruptions are suppressed and the symptoms are violent with spasms, etc.
Remember, then, the general characteristics that will easily
distinguish Bryonia from other remedies. The irritability of the patient, the vertigo from raising the head, the pressive headache, the dry, parched lips, mouth. etc., the excessive thirst, the bitter taste, the feeling of a stone in the stomach, the sensitive epigastrium, the large, dry, hard stools, the stitching pains, the dry cough as if coming from the stomach, the rheumatic pains and swellings worse by motion and tough, the dropsical effusions, into serous and synovial membranes.
It is complementary to Alumina which is similar in gastric and abdominal symptoms, constipation, throbbing headache, dry cough with stitches in the chest and dryness of mucous surfaces. Alumina often follows in constipation. With alumina there is neither desire nor ability to pass the stool. Even a soft stool requires much straining. Alumina is worse from potatoes. The constipation of Veratrum is similar to that of Bryonia.
Rhus and Bryonia follow each other well but they are antidotal if given together.
The value of our remedies cannot be measured by pathological anatomy. Natural and drug diseases are two entirely different conditions; the laws of one have no power in the other, nor can they have any, because those conditions, are not only different from, but totally opposed to one another.
It is for this reason that even as early as 1834 I told my pupils as Allentown: In studying a disease, think that all remedies may help in the case; in studying a remedy, think that it may help in every disease. This proposition, which I think comes from Fechner disease. This proposition, which I think comes from Fechner or Helbig, has been made a cornerstone by me. Disease does not mean a single case. I know very well that there is such a thing as classification of disease; but pathological anatomy does not reveal the boundaries of disease; it exhibits extreme points, but points are no lines.- C. HERING, M.D., 1847.