FOOTNOTES:
[L] The definite article is used because it is believed to be complete, thanks to the scholarship and courtesy of Dr. Henry M. Smith, of New York. To him, also, am I indebted for the original text of Pothos fœt. from the Correspondenzblatt.
Pothos Fœtida Symptomatology.
Translated from the Correspondenzblatt by T. C. Fanning, M. D., Tarrytown, N. Y.[M]
Because the odor is quite like Mephitis it is considered a so-called anti-spasmodic.
Abstract of symptoms from Hering, Humphreys, and Lingen.
So absent-minded and thoughtless that he enters the sick rooms without knocking; pays no attention to those speaking to him. Irritable, inclined to contradict; violent.
Headache of brief duration, in single spots, now here, now there, with confusion. Pressure in both temples, harder on one side than on the other alternately, with violent pulsation of the temporal arteries.
Drawing in the forehead in two lines from the frontal eminences to the glabella, where there is a strong outward drawing as if by a magnet.
Red swelling, like a saddle, across the bridge of the nose, painful to the touch, especially on the left side near the forehead, while the cartilaginous portion is cold and bloodless; with red spots on the cheek, on the left little pimples; swelling of the cervical and sub-maxillary glands.
Unpleasant numb sensation in the tongue; cannot project it against the teeth; papillæ elevated; tongue redder, with sore pain at point and edge.
Burning sensation from the fauces down through the chest. With the desire to smoke, tobacco tastes badly.
Pain in the scrobiculus cordis as if something broke loose, on stepping hard.
Inflation and tension in the abdomen; bellyache here and there in single spots; on walking, feeling as if the bowels shook, without pain.
Stool earlier (in the morning), frequent, softer.
Urging to urinate; very dark urine.
Painful, voluptuous tickling in the whole of the glans penis.
Violent sneezing, causing pain in the roof of the mouth, the fauces and œsophagus all the way to the stomach, followed by long-continued pains at the cardiac orifice.
Pain in chest and mediastinum posticum, less in the anticum, with pain under the shoulders, which seems to be in connection with burning in the œsophagus. Pressing pain on the sternum.
Sudden feeling of anxiety, with difficult (or oppressed) respiration and sweat, followed by stool and the subsidence of these and other pains.
Inclination to take deep inspirations with hollow feeling in the chest, later with contraction in the fauces and chest.
The difficulty of breathing is better in the open air.
Pain in the crest of the right tibia.
Rheumatic troubles increased.
Sleepy early in the evening.
All troubles disappear in the open air.
In attempting to analyze this "abstract of symptoms," to see if the internal evidence tends to show that the recorded effects are genuine results of the drug, it is well to remember that these provings—for we infer that three observers participated therein—were made in the light of the empirical history of Pothos fœt. The said history was on record before the date of these provings, and it cannot have escaped Hering's eye; he was too wide a reader for that. He was, beyond doubt, aware of the pathogenetic effects observed by Bigelow—headache, vertigo, temporary blindness, vomiting, even from small quantities. Having, then, this clue to its physiological action, these symptoms should reappear in his proving if his imagination furnished his symptoms. As only a mild headache is noted in the Correspondenzblatt, it is evident that these provers did not work from a pattern. It is also evident that the usus in morbis did not suggest the Allentown symptomatology, for the anti-asthmatic virtue of Pothos fœt. is one feature on which the greatest stress had been laid, and yet the only pathogenetic suggestion of its applicability in asthma is: "Sudden feeling of anxiety with difficult (or oppressed) respiration and sweat, followed by stool and the subsidence of these and other pains." Who ever heard of an asthma relieved by stool? Who could have invented such an odd modality? As it stands it is an unicum, and by every rule of criticism this single symptom-group gives the stamp of verity to the Allentown "abstract of symptoms." But there is other and singularly convincing evidence of the genuineness of this abstract. As the reader is aware, Thacher had emphasized the efficiency of Pothos fœt. as an anti-spasmodic in hysteria, although the "key-note" that indicates it in hysteria had wholly escaped his discernment.
Now this very "key-note" appears in the Allentown pathogenesis, but so unobtrusively as to show most conclusively that the prover who furnished it did not recognize its singular import and value. Such testimony is absolutely unimpugnable by honest and intelligent criticism.
It is also apparent that some of the less pronounced of its empirical virtues are reflected in the proving. For instance, Thacher found it efficacious in "erratick pains of a spasmodick nature." Is not this "erratic" feature reproduced in such conditions as:
"Headache, of brief duration, in single spots, now here, now there?"
"Pressure in both temples alternately, harder on one side than on the other?"
"Bellyache, here and there, in single spots?"
Brevity of duration and recurrence "in single spots, now here, now there," are phenomena at once spasmodic and erratic. It must be admitted that the trend of its pathogenetic action and the lines of its therapeutical application are parallel, and, therefore, that the latter are confirmatory of the former.
With such an anti-hysterical reputation as the empirical use had given to Pothos fœt., it might fairly be anticipated that its pathogenesis would be distinguished by a paucity of objective data, for only a tyro in pharmacodynamics, or a "Regular," would expect to find a full-lined picture of hysteria in any "proving." And so we have in the "abstract" a flux of subjective symptoms, "erratic" enough for hysterical elements, and still further characterized by an apparent evanescence, as if its phenomena of sensory disturbance were as fleeting and unsubstantial as those of an hysterical storm.
The will-o'-the-wisp-like character of its subjective symptoms, and its physometric property (hinted at in the pathogenesis and emphasized in Thacher's case) are the features that will chiefly impress one in studying this distinctively American remedy.
That the "abstract of symptomes" evinces a cautious trial of this drug, and that more heroic experiments will add to our knowledge of its pathogenetic properties, are plain deductions from the absence in the "abstract" of such pronounced effects as Bigelow observed and also from the evidence of the usus in morbis. The remedy needs an efficient proving, especially in the female organism.