Pulsatilla in inefficient labor.
Related entries: Pulsatilla
HERBERT T. WEBSTER, M.D., OAKLAND, CAL.
Like most Eclectic remedies, pulsatilla has an ancient history. Before Hahnemann, even though his followers claim it as a Homeopathic remedy, it was made prominent through its specific influence on the eyes by Baron Storck. We will not, then, do ourselves proud by proclaiming ourselves its discoverer, or even by claiming any new uses for it. This remains for our posterity, if new application should ever be found. However, it might be profitable to look over our present application of it to disease, and ask ourselves if we are taking advantage of what the past has afforded us in improving all the valuable uses to which it may be put.
In a copy of the United States Dispensatory, bearing date of 1888, I find the following testimony as to its therapeutic value—a fitting commentary on old school opinion of new school therapeutics. Of course, it was written twenty-seven years ago, and there has been some awakening since, though not among the majority of teachers in old school colleges. But to quote: "We have no actual knowledge as to the action of this new officinal. It has been employed in Germany and other parts of Europe, especially by Homeopathic practitioners, by whom the drug is much used for the relief of amenorrhea and dysmenorrhea, and for other purposes. Given in infinitesimal amounts, with due ceremony as to dilution, tumblers and spoons, to credulous, hysterical women, it may sometimes be of service; but whether it has any application is very doubtful." No wonder that with such text-books the Allopathic branch is full of doubting Thomases.
The last edition of the American Dispensatory contains a very lengthy description of the therapeutic uses of pulsatilla, but omits its important application as a partus accelerator. Few of our writers on the remedy refer to this. It seems to have been overlooked, and yet I believe this is one of its most important functions.
As a safe and reliable remedy when the pains are inefficient and distressing, I have never found any other remedy so satisfactory as pulsatilla. Conditions are almost invariably changed for the better before the second dose is administered. At least, a few small doses, administered from fifteen minutes to half an hour apart, alter the labor favorably within a reasonable time. I can not indorse all that some Homeopathic authors claim for it in parturition, but perhaps I have not given it credit for all it is able to accomplish.
A little review of two leading authorities in that school may not be amiss here, for we all have something still to learn, and even an old acquaintance may possess some new charm. I am glad to appropriate anything good, whether it emanate from Homeopathy or from an ancient grandmother. Regarding the action of pulsatilla in labor, Kent, one of the comparatively late prominent authors, remarks: "Shivering in the first stage of labor. Hysterical manifestations through labor. Pains have all ceased or are irregular, so that they do no good. No dilatation has taken place. But when the pains come on we have some important symptoms. A pain comes on and it seems to be about to finish satisfactorily; it has been regular and prolonged until about two-thirds through, and all at once she screams out and grasps her hip—the pain has left the uterus and gone to the hip, causing a cramp in the hip, and she has to be rubbed and turned over. This medicine will regulate the pains, and when the next pain comes it will hold on to the very end. So impressionable is this woman during confinement that if she is subjected to any emotion, such as having an emotional story told in the room, or if anything excitable occurs, the pain will stop. If she has passed through labor and the lochia has been established, from such a cause the lochia will stop, as if she has taken cold, and she will have cramps and troublesome after-pains, the milk will be suppressed, she will feel sore and bruised all over, and have fever."
I have frequently been called to labor that has been in progress for eight or ten hours and made a preliminary examination, expecting from the report of the nurse to find labor well advanced, to be surprised in finding hardly any dilatation at all. Another surprise has followed when, after administering pulsatilla, dilatation has gone on rapidly, labor terminating speedily and satisfactorily. In such cases pulsatilla undoubtedly favors relaxation of the os. It may not do this by acting as an antispasmodic, like lobelia or gelsemium, or jaborandi, but by correcting an improper distribution of the nervous impulse, which has acted to retard matters.
The excruciating, inefficient pains which sometimes usher in and continue through the first stage, seem to be speedily improved by the action of pulsatilla. Like macrotys, its action is invariably harmless, even if ineffective, so one does not go very much wrong if disappointed in its remedial action.
Some of the Homeopathic claims for the remedy seem to be rather extravagant, but even here I do not care to pose as too severe a critic. What I know about therapeutics I know, but I realize that there are many things I do not know, and find that I can learn something almost every day. That pulsatilla is capable of turning a child during labor seems like endowing it with an intelligence. I believe in specific affinity in therapeutics, but not in intelligence, so far as the action of a remedy is concerned. However, there are Homeopaths who assert that such is the capability of this remedy. The following from Hughes illustrates as well as affords some really useful hints as to the action of pulsatilla in other respects:
"It presides in a most beneficial manner over the function of parturition. Given daily for a month or so previously, it greatly facilitates the process in women whose labors are tedious and difficult. In labor itself, when the pains are irregular, tardy and defective, yet ergot is hardly called for, pulsatilla will often do good service, as also when from the same cause the placenta is unduly retained. There are several cases recorded which leave little doubt but that in false presentations pulsatilla favors spontaneous version. You may smile at this property I have ascribed to this remedy, but you must remember that in these cases spontaneous version is not so uncommon an occurrence, which shows that nature has means of effecting the change, and may well be helped thereto by an appropriate drug stimulus. The evidence that pulsatilla does render such aid comes from several practitioners, both in France and in America. And if you suggest that the cures they report may have been instances of spontaneous version of which I have spoken, I will adduce the testimony of Dr. Mercy Jackson, of Boston. In a communication made by this experienced lady to the American Institute of Homeopathy in 1875, she relates fifteen successive cases of false presentation, being all that had occurred in her practice from a certain time onwards. In every case she administered pulsatilla, and in every one the body underwent rotation and the head came to the fore. It is beyond all probability that these fifteen cases should have been a series of coincidences." With all due respect for Dr. Hughes and Dr. Mercy Jackson, now, I believe, deceased, we have it to remember that in her writings she asserts that she has felt a procidentia uteri rise into the pelvis so rapidly after taking sepia that its movement was plainly felt, as if raised by a power within the pelvis, and must accredit her with a remarkable imagination.
Still, after all is said and done, those who give pulsatilla a fair and impartial trial in parturition will hardly be disappointed in its favorable action wherever it is possible for a parturient to accomplish therapeutic effect.
I add twenty or thirty drops of the specific medicine to four ounces of water and order a teaspoonful every fifteen minutes, twice, then every half hour or hour, as circumstances demand.
DR. H. C. SMITH (Glendale): In regard to pulsatilla in labor, I use it considerably and it has a specific application there, as do lobelia, gelsemium and macrotys. In our discussion of the "Twilight Sleep" yesterday, I did not mention that we must insist that we use our specific remedies according to specific indications, especially those that relieve irritability of the nervous system, and in nine cases out of ten we will not need "Twilight Sleep." It is in the first stages that these remedies are usually indicated. We have had sufficient study of this matter to prove that the effect is on the sensory side of the nervous system and on the sympathetic nervous system; therefore, the labor that is retarded by hypersensibility of the nervous system will be relieved by pulsatilla and the labor will go on unretarded.
DR. F. M. CHANDLER: One other condition that has not been mentioned, where we are called a case and the woman is having some pain, irregular and inefficient in character, and there is question whether the uterus is trying to get busy or whether they are false pains, one or two doses of two or three drops each, which I usually combine with macrotys, will settle the thing in a very short time.
DR. E. G. SHARPE: I want to emphasize what Dr. Smith has said about pulsatilla as an accelerant of labor, but I have found it does not work the same in all cases, and we must select our cases as to the characteristic indications for the remedy. The patient that shows symptoms of lack of confidence, fear, etc., a dose of pulsatilla seems to benefit, and it answers the purpose as no other remedy will do.
DR. WEBSTER (closing): I am very much pleased to accept the comments that have been offered. They should have been in my paper.
National Eclectic Medical Association Quarterly, Vol. 7, 1915-16, was edited by William Nelson Mundy, M.D.