The root of Podophyllum peltatum.—U.S.
Preparations.—The powdered root. A tincture. Podophyllin.
Dose.—The dose of the powdered root is from gr. j. to grs. xxx. Of the tincture, from the fraction of a drop to gtt. xx. Of podophyilin, from 1-100 of a grain to gr. j.
Therapeutic Action.—Podophyllum is cathartic and alterative, and exercises a specific action on the liver. It produces irritation and suppuration when continually applied to the skin, and irritation when applied to mucous membranes. Taken in small doses it acts slowly as a cathartic, producing but little if any nausea; but when administered in large doses it produces violent emeto-catharsis. Though we have no well authenticated instances of death being produced by its administration, yet we have seen severe and long-continued gastro-intestinal irritation follow its injudicious use.
As a cathartic it is one of our most valuable indigenous remedies; and indeed one of the most important in the materia medica. It is a safe, certain, tolerably active deobstruent, and hydragogue cathartic, operating very efficiently, though not so promptly as jalap (which in its action it resembles), and some other agents of this class; yet when it commences operating, its action is continued for a longer time. Considering the thoroughness of its action, it produces but little tormina; though in full doses it often operates as an emeto-cathartic, causing great nausea, and protracted vomiting. It leaves the bowels in a lax or soluble condition for a long time.
During the early stages of many febrile diseases, particularly intermittent and bilious remittent fevers, Podophyllum is an agent of superior efficacy. A single dose often arrest the severest attacks of fever. The nausea and vomiting, the depletion, its derivative powers, the general relaxation, the active and protracted influence upon the bowels, together with its powerful action upon the glandular apparatus, particularly upon the liver and portal circle, render it an article of great importance in these cases.
During the early stages of all fevers, and even after the disease is somewhat advanced, if there is not a state of prostration contra-indicating the use of any active cathartic, this article will prove one of our most valuable curative agents. It is also valuable in most inflammatory diseases. One of the principal sanative uses of this agent arises from its protraced action, thus preventing a recurrence or subsequent exacerbation of the fevor; another is its powerful derivative and deobstruent influence upon the system.
In torpor or congestion of the liver, in jaundice, in any derangement of the hepatic functions, mercury, that Samson of the materia medica, dwindles into insignificance when compared with this simple and common plant.
In chronic or mercurial rheumatism, in scrofulas, in enlargements or indurations of the glandular system, and in torpor of any of the secretory organs of the body, the podophyllum, as an alterative discutient and revulsive cathartic, stands, we believe, altogether unrivaled in the list of remedial agents. In syphilis, during its primary, secondary, or tertiary stages, as an excitant and alterative, as well as a cathartic or aperient, it is of unquestionable importance. In short, in all these chronic diseases, the podophyllum is so searching in its influence, leaving not a single organ, tissue, gland, or secreting surface untouched, as to command an enviable pre-eminence, compared with other agents in common use. The continued or occasional use of it, either as a cathartic or as an aperient, throughout the whole course of medication, is strongly recommended in the chronic diseases named, from the sanative influence secured by the administration of it, during many years, and in a large number of inveterate cases.
It is beneficial in cases of dyspepsia, especially when attended with a torpid state of the liver and bowels; it restores the secretion of the liver, and promotes intestinal secretion, and most effectually counteracts constipation.
As a hydragogue cathartic, it proves highly antiphlogistic in synochal grades of fever, and in high grades of inflammatory action; and this influence is materially increased by combining it with the bitartrate of potash. The same combination is one of great utility in dropsy: one drachm of podophyllin combined with five drachms of bitartrate of potash, and given in drachm doses, and repeated five or six times per day, will produce profuse watery evacuations, and rapidly remove dropsical effusions. In those forms of dropsy arising from visceral obstruction the same combination will be found very useful as a deobstruent and hydragogue cathartic. In amenorrhoea dependent on cold, or arising from torpor of the uterus, a single dose of this agent will often speedily restore the uterine secretion, even when the obstruction has continued for several months. It is recommended to be administered on going to bed, as it is less apt to produce nausea and unpleasant effects.
Specific Indications.—Full tissues, full veins, full abdomen, full tongue dirty from base to tip, heavy headaohe, giddiness.
Specific Uses.—Following the indications as above, the reader can not go astray in the use of this remedy, whether he gives it in large or small dose. It does not make any difference what the name of the disease may be, or where it is located, if indicated, Podophyllum will aid the cure.
I wish to call especial attention to the remedy in diseases of the brain, especially those marked by dizziness and weight in the head, and imperfect command of the muscles. In these cases it stands first among remedies, iodide of ammonium holding the second place.
In small dose, podophyllin is a stimulant to the sympathetic nervous system. Whilst its action is especially upon parts supplied from the solar plexus, it influences the respiratory nerves in a marked manner, and in a less degree the hypogastric. As a remedy in atonic dyspepsia, it holds a prominent place.
I find in practice that the small dose is quite as good as the large one in the majority of cases. Even if I wished to influence the liver, I should give a single dose daily of podophyllin gr. 1-20, hydrastia gr. 1/4, rather than the old-fashioned dose. The same is the case in disease of the brain, and in many other cases.
I usually carry the remedy in the form of small sugar-coated pills, each containing podophyllin gr. 1-20, hydrastia gr. 1/4. A second decimal trituration is an excellent form in which to administer the remedy, especially to children.