(A summary of a few provings upon women.)
My studies have, for years past, shown me the weakness of the Homoeopathic Materia Medica in respect of the physiological effects of drugs upon the peculiar organism of women. This is due to the fact that but few of the provers to whose observation we owe our Materia Medica were women. I have not been able to imagine any method by which this deficiency in the Materia Medica could be supplied, except by the voluntary acts of women, who should undertake to prove drugs.
And it has seemed to me improbable that this work could be performed with the requisite accuracy and intelligence unless the women who. should undertake it were educated in the medical sciences.
Finally, it appeared to me that women who had become by education and asquirements members of the medical profession, would not be likely to take a hearty and efficient part with us in the great work of perfecting the vital element of our science, — the Materia Medica, — unless they were recognized and received by us as fellow-workers on an equal footing in -every respect, for a similar reason to that which led Mr. Dickens to decline the Queen's invitation to give a reading at Windsor Castle, saying, "I will not appear as an artist where I should not be received as a mom," and, conversely, I thought- that if so received they would respond cordially and generously to an invitation to engage in the work for the promotion of medical science, and in a department in which they alone could work, and the completeness of which would be forever a monument of their ability and devotion.
When, therefore, at the session of the Institute in 1869 a resolution was pending which declared the eligibility of properly qualified women to membership, I determined to invite women who had joined the medical profession to engage in the labor of proving drugs, feeling confident that the results of their work would demonstrate how valuable and indispensable it is to the completion and perfection of our Materia Medica.
The results even thus far have justified this confidence. More than thirty women, most of them members of the profession, responded cordially to my invitation, and entered upon the work of drug-proving. One-third of the number have already reported results of a satisfactory nature, and of which I here present a summary.
The drug selected for proving was the Lilium tigrinum — the tiger-lily — which was introduced into the Materia Medica by Dr. W. E. Payne, of Bath, Me., who had communicated to us just enough to show that it had a powerful specific action upon the female organism. The symptoms were known, however, only to members of the Institute. I thought that by engaging a number of provers in different parts of the country, in a simultaneous proving of this drug, utterly unknown to most, if not all of them, I should receive reports which, if they should corroborate each other, would be very conclusive as to the action of the drug.
Inasmuch as this drug belongs by right of discovery to (< -) Dr. W. E. Payne, I have turned over to him the verbatim reports received from my provers, that he might incorporate them with his own, and prepare the whole for publication in the Transactions of the Institute.
The first proving, and which I shall give in greatest detail, was made under my own observation and direction, by a lady of 30 years, unmarried, a practicing physician, and who had always enjoyed good health, although quite susceptible to the action of drugs.
No. 1. She began her proving Oct. 1, 1869, by taking three drops of the 30 centesimal dilution of Lilium tigrinum thrice daily.
She reports as follows :
"I first noticed that I was more active ; things went ,easily. There was no other effect for four days, unless it was increased sexual instinct ; then sweetish nausea, with fullness of the abdomen, particularly after eating — even after .eating small quantities. But food does not increase the nausea ; no desire to vomit.
"On the 6th day moral symptoms were developed. I do not want to be pleased ; don't care to talk ; desire to sleep.
Slept well all night, with unpleasant dreams.
Omitted medicine two days, during which the nausea and full feeling subsided. At intervals the skin of the abdomen felt stiff and stretched.
On the 7th day took five drops of the 30, and in a few hours the nausea was much increased, with the same bloated sensation in the abdomen, particularly across the hips and in the region of the uterus ; darting pains in different parts of the head, some tearing pain in the lower part-of the abdomen from the region of the ovary down both sides.
I ate as much as usual, but felt no appetite for it ; was restless, with a desire to do something, but no ambition. A sensation of pressure in the vagina, and pain at the top of the sacrum extending to the hips.
"8th Day. Worse on going to bed ; can't go to sleep ; wild feeling in the head, as though I should go crazy and no one would take care of me ; thoughts of suicide ; how much opium would put me to sleep forever, and who would find my body, and who would care ; nausea constant.
"10th Day. Pain in the right iliac region, better during motion ; the head grows wild after I have been quite for a short time. At 2 P. M. of the 10th day (Oct. 10), took five drops of the 30.
Increased depressing weight over the pubes ; worse in the evening. The knees ache." No more medicine was taken by this prover.
Eight days afterward (Oct. 20th), she came to me to state her symptoms, her mind being in such a state that she could not herself record them. The following symptoms had come on the 20th (ten days after last dose), and steadily increased : A sensation in the pelvis as though everything was coming into the world through the vagina.
Last night is was very distressing, and not relieved by change of position. The dragging downward toward the pelvis is felt as high as the stomach and even the shoulders ; not relieved by lying down, though worse when standing ; a disposition to place the hand upon the hypogastrium and press upward in order to relieve the dragging sensation.
Likewise an aching and pressure across the lumb-sacral region, and some pressure upon the rectum. Likewise pressure and a crazy feeling upon the vertex, so that she cannot write her symptoms. To-day (22 d), when walking, a sensation as if everything were pressing down in the pelvis and into the -vagina, so that she inhales forcibly in order to draw up the thorax and clear the pelvis.
She wants somebody to talk to her and entertain her. Feels quite nervous ; wants to cry from a feeling of irritation and of something wrong in the abdomen and pelvis. Feels hurried and yet incapable, as if she had a great deal to do and cannot do it ; much thirst ; drinks often, and much at a time.
Bowels generally regular. Now she has alternately a solid and a loose stool, several during the day, and a constant feeling as though she must have a stool ; this feeling resulting from a sensation as if something were pressing against the anterior wall of the rectum at the anus and about one to. three inches above it.
She is conscious of feeling nervous and irritable, and yet 'says she feels jolly.
Grumbling pain in right side of head and teeth.
Yesterday, when walking, pain in both ovaries, worse in the left, extending down the anterior and inner aspect of the left thigh, as if it would be impossible to, take another step ;
Oct. 28. Menses occurred at the regular day and normal, but only while she keeps moving.
The flow ceases when she becomes quiet. She feels much hurried and driven, but knows not why ; walks fast and constantly, but aimlessly ; is much confused in mind.
Oct. 29. She noticed some heart symptoms, not very definite. On the 30th, after walking, a sudden fluttering sensation in the heart.
This, like all other symptoms, is less felt she can busy herself much.
A hurried feeling about the heart with faintness and fluttering as though she could-make no exertion but must sit still.
The seat of pain is the apex of the heart.
Twice she had a sharp pain there.
Feels hurried as though she must breathe quickly, yet does not.
The prover feels that her whole system has been profoundly affected by the drugs "She is not the person she once was ;" feels hurried but incapable ; no heart nor strength for business ; discouraged and despondent.
Nov. 1. A dry, single cough ; heart symptoms very troublesome ; short of breath, especially on going upstairs.
Appetite very much increased, especially for meat, and the more so the more pronounced the symptoms were.
The mental symptoms are striking ; she is averse to being alone, which formerly she liked (but does not dread it).
Her sexual instincts, formerly dormant, are now quite strong ; wits and intuitions dull and languid.
Nov. 10. The prover reports : She had been quite welt since the 4th, and supposed the action of the drug exhausted, but on the 7th the bearing down sensation in the pelvis returned ; everything seemed to be pressing out of the vagina.
This continued on the 8th like light labor pains.
Leucorrhoea also occurred (a thin acrid discharge, leaving a brown stain). She had never before had it.
All these symptoms worse afternoon and evening till midnight.
On the 9th leucorrhoea had ceased, but in the afternoon it returned worse than ever, and she could not sleep for the pelvic distress.
Nov. 11. She feels depression ; has pressure on bladder and rectum ; is inert, yet restless and peevish ; leucorrhoea continues.
With these symptoms comes the desire again for meat.
Burning pain across the hypogastrium from groin to groin. In short, the symptoms first experienced repeat themselves.
She had not taken any more of the Lilium tigrinum.
In addition she notices a peculiar mental condition ; a desire for fine things of every kind. She is dissatisfied with what she has, and envious of others.
Nov. 12. While attending a lecture, much irritation in the womb and a singular state of mind — desire to strike the lecturer, and in the evening a disposition to swear at everybody and everything, and to think and speak and of obscene things ; as these feelings came, the uterine pains passed away. To-day the leucorrhoea ceased.
Nov. 13. She has been languid, dull, and forgetful since the last report.
Menses recurrend (14th) after an interval of only two weeks ; a slight, dark, thick, and offensive discharge.
Dec. 1. It is eight weeks since she took Lilium tigrinum.
Yesterday, great hunger, and she ate largely, yet felt as if she should starve.
Felt the old hurry and incapacity ; the old pains in head and teeth relieved by motion and occupation, followed by the diarrhea and the pressure on the bladder.
Dec. 4. She is now passing this, the third series of symptoms produced by the Lilium tigrinum ; the passionate excitement, the aching and burning pain in the ovaries (in the right), which organs are distinctly defined to her sensation ; then despondency with aggravation at night and diarrhea in the morning ; then pressing down in the pelvis and burning all around the pubes and genitals, worse from 3 to 5 P. M., and passing away from 8 P. M., accompanied by pressure on the bladder.
The symptoms on this occasion were so severe and distressing — physical no less than mental — that I could not allow the prover to continue to endure them, and gave Platina 200 repeatedly, under which she gained speedy relief.
No. 2. To compare with the above, I will give an abstract of a proving made under the supervision of Dr. W. K Payne, at about the same time, the provers having no communication :
Mrs. P., aged 55 has ceased to menstruate.
Jan. 26, 1870, took a drop of the 30 centesimal. In the evening, after griping pain, had free, fecal stool, followed by acrid feeling in anus and rectum, a very rare thing for this prover. During the night, a feeling in all the extremities as if the blood were pushed outward ; restlessness ; heat and pain in forehead and brow.
Next day a free stool, followed by acrid sensation at the anus.
Frequent desire to urinate during the day, with scanty discharge and followed by an acrid sensation in the urethra.
These symptoms recurred daily with marked aggravation about 5 P. M. till February 2. Diarrheic stool every morning, followed by acrid irritation at anus, continuing about an hour. Same symptoms with urine.
Feb. 2. Repeated medicine.
Increase of the above symptoms ; burning in palms and soles all night, with constant desire to find a cool place for them ; some cutting pain in the left mammary gland, with aching, beginning below the nipple, deep in the breast, as though between the gland and the ribs and extending around that side to the spine, seeming to pass under the lower end of scapula, coming on after retiring and worse when lying on the affected side.
These symptoms continued and recurred daily ; she repeated the medicine, which was followed by a severe blinding headache in the anterior part of the head, the peculiarity of which was a sensation as if all the blood were pressing outward through every aperture. The medicine was repeated every third or fourth day. About the 9th and 10th, in the left side of the abdomen (ovarian region) soreness to pressure ; darting pains at times in this region, extending to the groin and pubes in front ; frequent desire to urinate.
On the 12th, the head being clearer and better, great heaviness and pressure in the region of the womb, with stinging and darting pain in the ovarian region.
14th. The ovarian pains becomes more decided and extend down the left thigh.
This series of symptoms continued until the 21st, when the ovarian pain continuing, there was also a bearing down in the uterine region, with a desire to sustain the parts by pressing upward with the hand against the vulva ; symptoms which continued and are described on the 25th as a pressing and bearing down sensation" in the whole of the sexual organs, with a feeling as if the internal parts were being pulled outward and downward from the mammary and umbilical region through the vagina ; irresistible desire to press the hands against the vulva to prevent the internal organs from escaping.
These symptoms continued to recur for a full month after the last dose of Lilium, and the morning diarrhea for more than six weeks.
No. 3. This prover took Lilium 3 in one dose a quarter ounce. No symptoms were observed for two weeks. Then, of which the most striking were those last in order, pain in the lumbar region as though the back would break ; bearing down pain in the pelvis, especially when walking ; pressure and weight low down in the vagina.
She reports, also, a headache, as if the head were too 'full of blood — as if the blood would issue from nose and ears.
No. 4. This prover, who had suffered from astigmatism, and was hypermetric, experienced from Lilium 3, heart symptoms, pain through the heart to the back, and a feeling as, if the heart were squeezed in a vice. She cannot walk straight by going into a warm room, the symptoms having occurred while walking in cold air.
Also, her eyesight became very dim. She took no more medicine, and in about a month her eyesight was restored. She then found that the astigmatism no longer existed.
No. 5. This prover describes the same headache as the previous prover — pressure from within outward ; the same nervous prostration, and a morning diarrhea with much tenesmus. She states the symptoms persisted for a month after the last dose.
No. 6. This prover reports nervous tremulousness and inability to apply the mind ; aggravation in the afternoon, and a headache similar to the preceding. Also, menses diminished in quantity, but occurring too soon. Likewise, severe pains in the uterus ; could not bear the weight of clothing on the pelvis ; profuse acrid leucorrhoea.
While the pain in the pelvis was so severe, a vaginal examination disclosed the fact that the uterus was anteverted ; a state of things that had never before existed.
During the pains hysterical paroxysms.
Nos. 7. and 8. The same series of symptoms as above.
From this resume we may gather some of the chief characteristics of Lilium. When taken in moderate doses the effects are not immediate. Days elapse before unmistakable symptoms of the drug-action appear.
But the effects, are very persistent, as the record of every prover shows.. They tend, moreover, to recur at longer or shorter intervals, and in groups which preserve a definite order.
Thus, prover No. 1, whose record I have given at 'greater length, reports, a third recurrence of a group of symptoms nearly two months after the dose of Lilium.
In male provers the same recurrence of symptoms in definite groups has been observed, with an interval of comparative freedom from symptoms. The simultaneous observation of these peculiarities in provers residing far from each other, and known to each other, precludes any doubt of its genuineness.
Of the symptoms observed by women, as well as men, the effects on the mind are noteworthy, and are of two varieties. First, as noticed by Dr. Payne, anxiety and apprehension that an incurable disease exists or is impending, and this produces despondency.
Second, as exhibited most decidedly in prover No. 1. and clearly, though less pronounced, in several others, a consciousness of an unnatural state of mind and feeling, which at last develops into an exalted condition in which the prover is disposed to find fault with persons and things, to exaggerate her own importance and excellence, and look down upon others ; conjoined with this is an exaltation of the sexual instinct. In several provers this state of things has resulted in hysterical paroxysms.
In prover No 1 it assumed such marked proportions I was constrained to put an end to it by administering Platina, the indications for which are evident from the mental symptoms. Intellectual activity is impaired in both men and women. Both have complained of the feeling of hurry and restlessness, which is so well described by prover No. 1.
Menstruation is accelerated, in some cases recurring in two weeks.
The flow is very scanty.
An acrid, thin, brownish leucorrhea was, to several provers, a troublesome symptom.
But the most striking symptoms, and those most widely observed, relate to the pelvic organs.
They did not generally present themselves until a number of days after the proving was begun. They consist of a dragging or pulling or forcing down sensation in the pelvis, as though the entire contents of the pelvis were pulled down through the vagina, or would issue from the vulva. This sensation is not confined to the back or hips, — nor again to the hypogastric region, — but is described as pervading the entire pelvis.
And the two provers in whom this symptom was most marked describe the. dragging as coming even from the thorax, the mammary region, and the shoulders.
So marked is the sensation of downward and outward pressure that -the provers place the hand on the hypogastrium or the vulva as though. to prevent protrusion. In three provers, physical inspection revealed the existence of anteversio uteri, a trouble which none of them had ever before experienced.
In this train of symptoms belong also the tenesmus of bladder and rectum, and the diarrhea and frequent micturition.
There is agreement of the provers respecting pains, burning or cutting, and tenderness in the region of the ovaries, especially of the right ovary.
The symptoms generally are worse in the afternoon and before midnight, except the diarrhea, which seems to be a morning diarrhea.
If now, with the light which these provings afford us, we seek to place Lilium tigrinum in its appropriate niche in our Materia Medica, and to estimate its value by comparison with other drugs, we observe, first : The uniform occurrence, in so many provers, of pelvic symptoms, as well as the demonstration, by physical examination, of the uterine displacement, establish its a priori claim to rank among the remedies for prolapsus and displacement of the uterus, for catarrh of vagina and uterus, and for inflammation of the ovary.
And if we run a parallel with the symptoms of other remedies, we find marked peculiarities which characterize Lilium. In the morning diarrhea, coming suddenly and with tenesmus, it resembles Podophyllum, and Podophyllum has, likewise, a general bearing down in the pelvis — confined, however, to the lumbo-sacral region, while the mental and moral symptoms produced by Podophyllum bear no resemblance to, those Lilium.
Moreover, in so far as my own observation goes, Podophyllum both produces and removes these pelvic symptoms only when they occur in connection with certain symptoms of the digestive tract, such as Lilium has no relation with.
Sepia produces, certainly, a bearing down sensation upon the lumbar region, together with dragging and even sharp pains from the region of the ovaries extending downward to the pudenda, but besides that, Sepia presents us no symptoms of diarrhea and irritation of rectum and anus, and no such leucorrhoea as Lilium ; the conditions are very different.
The Lilium pains are aggravated in the afternoon, and before midnight. They grow worse during repose and when one's mind is passive ; worse, therefore, on lying down and trying to compose one's self to sleep. Whereas, on the other hand, the Sepia pains are worse from 9 A. M. to noon,. and are relieved by repose ; being aggravated by motion and occupation. The state of mind produced by the two drugs is very different. Almost the same difference exist between Lilium and Pulsatilla.
Belladonna resembles Lilium in the bearing down sensation, both in the back and in the pubic region, and in the fact that there is not immediate relief from repose. But, on the other hand, Lilium gives no evidence of that general affection of the organism, especially of the circulation, which accompanies every well pronounced group of Belladonna symptoms.
On the contrary, under Lilium, when the patient suffered most, nutrition and appetite were not impaired. They were even improved.
It is probable that further provings of Helonias diocia will show a strong analogy between it and Lilium as regards. their action on the female organism. We know enough already to recognize a difference in the mental symptoms. Lilium dulls the intellect, produces a sensation of hurry with inability, and a distress based on a clearly defined apprehension of having some fatal or serious malady.. Helonias produces profound melancholy, deep, undefined depression, with sensation of soreness and weight in the womb,. a "consciousness of a womb."
Platina seems to me to present the strongest features of resemblance to Lilium, both in the pelvic symptoms and in at least one phase of mental symptoms, and the result of my trials with prover No. 1 shows its power\ to antidote Lilium. But Platina does not present any of the symptoms of the intestinal tract which are so prominent under Lilium nor are its effects on the function of menstruation similar.
It will be observed that I have said nothing of the action of Lilium upon the heart. This is because my provers were not very markedly affected in that way (except one of them), but chiefly because my purpose was to show the action of the drug on the organs and function peculiar to women, and to demonstrate how valuable additions may in a short time be made to Materia Medica in its weakest part by the labors of professionally educated women heartily engaged in this work, which none but such as they can perform.
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