Helonias dioica

 Chamaelirium luteum, Gray (Helonias dioica, Pursh; H. lutea, Ait.; с. сarolinianum, Willd; Veratrum luteum, Linn. Ophiostachys Virginica, Delile). Natural order: Liliaceae. Preparation: Tincture of the root.

 Mind.
 Very downhearted and discouraged (. (fourth day). Reaction (from feeling of general wellness) began, and for a fortnight I was in a mental hell; it was the most profound mental depression I have ever known; I was plunged into the most abject despair (twenty-seventh day). Very irritable during headache (from eleventh to fourteenth days). Previous to taking the remedy I never felt better, more cheerful, or in better spirits; soon after taking there was an entire change in the surrounding circumstances; I very soon became irritable, gloomy, and dull; could not endure the least contradiction or receive any suggestions in regard to any subject; all conversation was unpleasant, and what I most desired was to be left alone, reserving to myself the privilege of finding fault with everything around me; I consider that this moral condition was not accidental, but purely a pathological state, produced and kept up by the action of the medicine (seventh evening); previous to this evening this state assumed an intermittent form, but after this date it was unchanged for several days, and was one of the most constant and marked effects. Mind dull and inactive (fourth day).

 Vertigo. General Head. Slight pains in the head, which were accompanied by diminution of sight and vertigo on moving the head suddenly (after two hours and a half). The feeling of fullness in the head increases, and there is a sense of pressure from within up to the vertex; the latter feeling is aggravated by looking steadily at any fixed point (second day). A strange fullness in the whole head (the alcohol), (after half an hour, sixth day). Slight darting pains in the head. Forehead. Fullness in the forehead all through between the temples (five hours and twenty minutes after first dose, third day). Slight dull headache in forehead, extending towards the vertex (fourth day). Pain in the forehead, as if a band about an inch wide was drawn across from temple to temple (after second dose, seventh day). Temples. Slight pain through the temples, together with a feeling of fullness in the head and vertigo (after fifth dose, first day). Headache comes on every day at 4 or 5 , if not then, surely between 8 and 9 ; it is a dull aching in temples and forehead; pressure over the root of the nose; and when it is on, feel as if I had caught cold; am feverish without feeling hot to others or having an increase of pulse; at this time am also very irritable (from the eleventh to fourteenth day). Vertex. Pain in vertex, increased by stooping, and attended by increased vertigo (after second dose, fifth day). While reading, a feeling of fullness, pressure from within outwards, in vertex and occiput; at the same time the scalp seemed to burn; when I read earnestly, concentrating my attention, all these sensations vanished; but if I turned my attention from the book to my hand they were instantly perceived; I found that I could get rid of them or bring them on just as I liked (after four hours, first day). Great pressure on the vertex; it seems to return every afternoon (eighth and ninth days).
 Eye.
 It seemed as if the pupil admitted too much light, although upon examination it did not appear to be dilated (after two hours). The sight is affected; there is a sensation of much light, accompanied by indistinct vision, and on sudden and considerable motion of the head the patient is almost blind. If I turned my head suddenly around I became almost blind (after two hours). Much exertion produces complete blindness for the time being. On walking out, before I had proceeded two hundred yards I became blind. Upon this I stopped a short time, when the sight gradually returned (after two hours and a half).

 Have awakened every morning since the proving was commenced at 5 o’clock, an unusual hour, with tongue and fauces dry, and a bitter, disagreeable taste in the mouth (fifth day). Dryness and bitter taste in the mouth (after second dose, seventh day).

 Abdomen.
 Hypochondria. Pain in the left side, as if in the spleen; it felt as if that viscus was distended, and so much so as to cause a dull ache; it did not last long (fifth day). General Abdomen. вowels full of flatulence, and each eructation created a feeling of nausea (. (ninth day). A feeling in the bowels as if diarrhoea would come on, soon passing away, while at supper (after two hours and a quarter, first day). вefore stool, feeling as if going to have diarrhoea (fifth day). Bellyache before stool, relieved so soon as rectum was emptied (eighth day). Hypogastrium. вurning in lower third of abdomen, as if the whole pelvic bowl and up to a space midway between umbilicus and pubis were filled with quite warm water (six hours after second dose, second day). сolic like pains in hypogastric region off and on all day (ninth day).
 Frequently while walking (and only then), a sudden pang deep in the right groin; it would smite me suddenly as an electric shock, make me limp for a few steps, and soon pass away; pressure with the tips of the fingers in the groin seemed to relieve it; at least I was instinctively led into this manipulation, and relief seemed to come from it (seventh week).
 Anus.
 After stool, slight burning in anus (fifth day).
 Stool.
 Slight purging, with a burning sensation in the bowels. Two stools; very unusual, as my bowels are always A 1 (third day). Just after breakfast (my usual habit), stool, which is a little loose; one hour after, another, yellow and mush like (fifth day). Two small brown stools (eighth day). Yellow and mush like stool (sixth day). Morning stool was barely consistent enough to retain its shape (seventh day). Stool is first half hard, second half soft; first half dark- brown, second light-yellow (fourteenth day). A peculiar stool; sensation as if each lump of faeces has the shape of a large minnie bullet, which passed from the anus the big end first; the anus seemed to be much distended for an instant, and then out flew a fecal mass just as a pumpkin-seed shoots from the fingers; the stool consisted of four lumps which made their exit separately, but as fast as they could follow each other, for it seemed as if each single one had to work its passage by forcing upon the anus; in the evening (fourth day).

 Appetite. Appetite has not been as usual (fifth day). Eructation. Tasteless eructations (after two hours and a half, sixth day). Many tasteless eructations through the day (ninth day). Nausea and Vomiting. Nausea, as though vomiting would follow, while at supper, soon passing away (after two hours and a quarter, first day). Nausea, and commonly vomiting, but without relief of symptoms. Sick at the stomach and rejected my dinner, which seemed to be in a state of fermentation (after two hours and a half). Stomach. An indescribable sensation in the epigastrium. Irritability of the stomach. Vague distress in stomach, in the forenoon (fourth day). Indescribable distressing sensation in the epigastric region (after two hours and a half). Sensation of pain, tightness, and pressure in the stomach, which was partially relieved by the eructation of tasteless gas (after each of three first doses, first day). вurning in stomach (after two hours and a half, sixth day). A glow is felt in the epigastric region, apparently referable to the stomach itself, accompanied by an occasional sensation of flashes of heat through the whole system (after two hours). A genial glow in the stomach, with occasional flashes of heat (after two hours). Sensations of heat and cold in the region of the stomach (after two hours and a half). сramp like pain in the stomach (soon after first dose, seventh day). It acts as an emeto-cathartic, producing a griping-burning sensation in the epigastrium, and great activity of the salivary glands.

 Kidneys. A great deal of weariness, and feeling of weight in the region of the kidneys, and with much more general fatigue than usual, in the afternoon and evening (fourth day). Pain in the kidneys, which is followed by albuminuria, indicating congestion, and large discharges of urine, with slight increased specific gravity. A sensation as if my kidneys were two bags of hot water; this feeling was so distinct, that I felt certain I could have traced the area occupied by these organs by following the outlines of the burning (fifth day). It seems as if the kidneys ache at 10 (eighth day). Urethra. Urination was very painful, on account of the scalding sensation as the urine passed over the denuded mucous membrane). Irritation of the urethra. Micturition. Kidneys somewhat stimulated, and a larger amount than usual of clear, light-colored urine has been voided during the past twelve hours, in the evening (second day). Every time I urinate I seem to completely empty the bladder, yet when I have put the ‘indefinite article back in my breeches, out spurts a quantity of urine; no matter how much I endeavor to contract the bladder, this extra leak happens every time I micturate (sixth day). To this day, February 4th 1871 (nearly three years), I have not overcome this weakness. At I was ever very sure on the trigger, I am the more willing to ascribe this to the Helonias. In functional derangements of the prostate, it will be well to bear this remedy in mind, for if this prostatic freak obtains and is attended with somewhat frequent and profuse urination, the urine being very pale and watery, or containing a deposit of the amorphous phosphates, Helonias promises fairly. I may here add, that a close examination reveals no enlargement of the prostate in my case. Since the proving, the presence of a deposit of the amorphous phosphates in the urine is the exception, and not, as previously, the rule of my life. Urine. Urine had a faintly alkaline reaction before the proving; neutral (after four hundred and eighty minutes, sixth day); strongly acid (seventh day). The design of this whole experiment was, if possible, to induce saccharine or albuminous urine. From the specific gravity, it will be seen that there is little chance of finding either. The test by heat alone would have led to the supposition a that albumen existed, from the flocky curdling of the phosphates, but Nitric acid never gave an albuminous precipitate. The sugar was sought for with Fehling’s test, freshly prepared, and invariably with negative results. The urine was carefully examined with the microscope throughout the whole research, and the results show that the action of Helonias upon the kidney is purely functional. There is no evidence of any epithelial desquamation, or degeneration, and Helonias, as a renal remedy, may be classed with сantharides, but not with Arsenic or Phosphorus. So far us my experiment is concerned, these three facts are sufficient to justify the job; the other fact, that Helonias can render a neutral or an alkaline urine acid is a clear gain. I think it must be allowed that Helonias is somewhat diuretic; a daily average of 46.347 ounces is certainly a plus for one of my stature and weight. I do drink water freely, but I chew tobacco, and my spittoon will testify that the salivary glands, do extra duty. I think the primary action of Helonias is to reduce the renal excretion. When this remedy is in full action, the kidneys have an even burning feel, and they ache; evidence, I take it, of renal congestion, retarded blood flow, hence the urinary plus. On March 28th, 29th, and 30th (fifth, sixth, and seventh days of the proving), 1380 minims in all were taken. A glance at Table II will show the effect upon the renal excretion. It decreases from 57 1/2 ounces to 24 ounces 3 drachms. Three days’ time are required with the doses taken, then the drug is suspended, and in the next three days the quantity of urine increases from 24 ounces 3 drachms to 73 ounces; a plus of nearly 50 ounces. On the following day, it falls from ounces to 47 1/2. Such variations are beyond even the maximum of physiological oscillation. On the 26th, I dined at 12, emptied the bladder at 1 , and again at 2. The rate of excretion was 2 1/4 ounces in an hour. On the 29th, I repeated this process, and found the rate to be 7 1/4 ounces in an hour. On the latter date, at 12 M., I had taken 480 minims of the tincture. Possibly this phenomenon of renal stimulation may be ascribed to the alcohol. However, as the tincture was diluted with thrice its quantity of water, it is as probable that the stimulation is due to the Helonias. According to вocker and Hammond, alcohol lessens the water of the urine, and this must be borne in mind in estimating the downward slope of the quantity line for the 29th, 30th, and 31st. The decrease begins on the 29th, and reaches the minimum on the 31st, the whole quantity eliminated being 128 1/8 ounces. The increase began on April 1st, and reached the maximum on April 3D, the whole quantity 163 1/4 ounces. The reaction is plus. These quantities added, give 48.55 ounces as the daily mean, another plus. As a like quantity of water was drank daily, and as no change in the temperature of the weather occurred to explain this plus by skin action, I am disposed to ascribe it to the drug. If we assume 45 ounces as my daily rate of excretion, which is certainly liberal, we shall find that nine of the nineteen days give a quantity below this, while the remaining ten are above it. The nine minimum days give, as a total, 350 7/8 ounces, which is 38 3/10 ounces per diem. The ten maximum days give 551 3/8 ounces, 55 13/100 ounces daily. If we take enough from the maximum, ten days’ quantity, to bring the minimum, nine days’ quantity, up to the mean of 45 ounces per diem, we still have a plus of 46 3/8 ounces. That Helonias is a diuretic in the same sense as Apocynum cannabinum, I am not prepared to affirm; that it is a renal stimulant, I think may be safely assumed. Let not the term stimulant mislead. The Helonias renal stimulation is a condition of debility, renal paresis, the result of previous arterial tonic contraction. Helonias lowers the specific gravity. A mean of 1.01571 for nineteen consecutive days is not normal. Suppose that, on account of the experimenter’s sedentary habits, we assume 1.018 as the normal specific gravity of his urine, we then find that under the Helonias action it is for fourteen days of the nineteen below this, and that for seven of these fourteen days it is at 1.014 for two, 1.013 for three, and 1.012 for two. A glance at Table II will show that the depression of specific gravity is not directly dependent upon the quantity of urine excreted. On different days we have 73.572 and 47.7 ounces, each of 1.013 specific gravity; 46, 43.4, and 24.3 ounces of 1020; 42.3, 39.4, 37.2, and 36.5 ounces of 1.017. The consideration of this leads us to the urea. As the daily average, according to Table II, exceeds the physiological amount by nearly 50 grains per diem, one would say that the primary action of Helonias is to increase the elimination of urea. A glance at Table II will show that on only seven of the nineteen days did the urea fall below the daily rate of 345.94 grains, and the greatest minus will be found to coincide with the days in which a great amount of alcohol was taken. In three days, 28th, 29th, 30th (of March), 1380 minims of tincture were drank, and in the urine of the 29th, 30th, and 31st, the effects of the alcohol is shown in a minus of 130.58 grains of urea. On twelve of the nineteen days there is a plus of urea, which extends from 9.76 to 215.26 grains daily. So far, then, as these data go, we must believe that Helonias primarily increases the elimination of urea.
 Sexual Organs.
 Great uterine hemorrhage came during the proving, and continued until the medicine was discontinued. An intense irritation of the external labia and pudendum, which were puffed, hot, red, and burned and itched terribly; so intense was this irritation, that she could not prevent herself from scratching with her nails until the surface bled; every morning the cutaneous surface would fall off in thin, transparent exfoliations; the mucous membrane of the labia was red, swollen, and covered with a white, curdy deposit, like aphthae; the speculum showed the inflammation to reach one-third the length of the vagina).

 A feeling as if respiration were about to cease.
 Chest.
 My chest seems to be unusually sensitive to the air; it was a fine, sunshiny day (March 29th), but I felt the cold very sensibly down the front of my chest, the whole length of the sternum, and in a space as wide apart as the nipples (I wore at the time a vest which buttoned up to the throat, but I still felt what seemed to be cold air penetrating even through the turned-in front of my overcoat), (sixth day). Aching pain in my chest, as if all my strength had left me from excessively hard work; it is a tired aching, as if the whole front of the chest, and especially a strip some four inches wide down the whole front of the sternum, had been compressed in a vice (I have felt similarly when overworked in the army, but I have done no work now to account for this) (fifth day); felt while walking nearly a mile (sixth day). вreasts swollen, nipples tender, and will not bear the pressure of even an ordinary dress; nipples very sensitive and painful.

 The pulse ranges at 84, full and a little irregular, in the evening (second day). Pulse at the wrist weak, hardly perceptible, and about 60 beats in a minute (after two hours and a half). Pulse weak and quite infrequent. Pulse small, weak, and sometimes as infrequent as 40 beats in a minute. Pulse very small, and only about 40 beats in a minute (after four hours).

 Back.
 Back very lame and aching (ninth day). Pain and feeling of lameness in the whole back (after second dose, seventh day). Sharp, spasmodic pain in the back, running to the chest of the left ilium (after second dose, fifth day). Dorsal. вurning in the spine (upper dorsal), (fourth day). вurning in the back between the shoulder-blades, and a tired aching in lower lumbar and sacral regions (tenth day). Great heat and burning in the dorsal region, especially marked in the space between the lower half of the scapula, when sitting reading at night (fifth day). Lumbar. A tired ache in the spine (lower lumbar and sacral regions), (fifth day). вack across lower lumbar region feels very tired and weak (eighth day). After resting in my office an hour, I notice a very tired feeling in the lower lumbar and sacral region (fifth day). вack lame, and fairly aches (lower lumbar and sacral regions), (ninth day). Pain in the lumbar region, about the upper part of the sacrum and pelvis; these pains during the last twenty-four hours have been more constant and severe than at any other time; the pain in the back seems more troublesome at night than during the day (twelfth day). вurning and aching in spine (lumbar and dorsal regions), (after two hours and a half, sixth day). Slight aching in back (lower lumbar and sacral regions), (fourteenth day). Tired ache in back (lumbar and sacral regions), (after dose, seventh day). Tired aching sensation, and a burning in the spine (lower lumbar and sacral regions), on sitting down, at 3.30 (eighth day). Feeling of weariness and weight in the region of the kidneys (after fourth dose, second day). Dull heat, hardly a burning, in the renal region (two hours and a half after first dose, second day). Sudden and momentary but very acute pang of pain in the region of the kidneys, as if I had been shot there, when undressing (first night). Pain in the lower part of the back through to the uterus, like inflammation, piercing, drawing. Sacral. Feel a little weak in the back (sacrum), (fourth day). вurning in the sacral region (after one hour and three- quarters, sixth day). Just a perceptible dull feeling in sacral region, in the morning (seventh day). Aching pain in sacrum, which also extends down into each buttock, at 4.45 (fourteenth day). Severe aching in sacrum, in the afternoon (fourteenth day).
 Inferior Extremities.
 A burning, or rather a warm numbness in the legs, most marked in the knees; (it was like the Aconite anaesthesia, but not so intense); it seemed to begin at the tendo Achillis of each leg, streaming upwards, and was very marked over the region of each gastrocnemius; at times my legs feel almost as numb as they have done from a ten-minim dose of Fleming’s tincture of Aconite (fifth and sixth days). Severe rheumatic pains in the right hip- joint, more during motion (seventh day). Painful aching in right ankle-joint as if a wedge were driven in; this lasted until I feel asleep at night (second hour after second dose, second day); although disagreeably painful it did not interfere with locomotion (after second dose, third day). Numbness in my feet, which goes off by motion, and is only felt when sitting still (sixth day).

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