Piper methysticum

Volume I — Appendix

(Kava-Kava.)

Description. — A plant indigenous to the islands of the Pacific Ocean. It grows to a height of 6 feet, and has a slender stem. The leaves are large, and as broad as long. 10 or 12 prominent veins radiate from the petiole, the 3 central ones being very close together. The root is large and fibrous, but light and spongy in texture.

Preparation. — Tincture of the root.

Mind.

When concentrated, drunkenness is almost instantaneous; with the ordinary dose, it occurs about twenty minutes after ingestion. In a small dose kava is a tonic, stimulating beverage, producing an agreeable excitement, and affording support against great fatigue. In increased doses, this root determines an intoxication of a sorrowful, silent and sleepy character, completely different from that produced by alcoholic drinks. The habitual drinkers of kava take it six or eight times a day, but then a nervous trembling seizes them, and they can scarcely raise the cup to their lips. The intoxication does not last longer than two hours, but if a person only takes it occasionally, the effects may continue

twelve ; when taken at intervals of some days, the intoxication continues for six hours. When made from the root grown in damp soils, the drinker remains plunged in a deep torpor, and becomes irritated by the least noise. Often when the dose is too great or too small, instead of the sleep an intoxication, accompanied by fantastic ideas and a strong desire to skip about, although one cannot for a moment hold himself on his legs. Felt all day unusual life, vigor, and exhilaration. Felt more lively than usual ; in better spirits; inclined to work. Capable of doing more work, without fatigue or brain-fag.

Head.

Dizziness and frontal pressure, even when lying in bed in the morning.

From 5 to 9 p.m. unusual dizziness, swimming sensation and faintness.

Pains, especially of the head, relieved temporarily by turning the mind to another topic.

Awoke with very worn feeling of the brain, decided brain-fag ; getting on foot felt better.

Headache and sleepiness so great as to interfere with work. Head ached all night with fulness of frontal region. Feeling as if the frontal region was solid with pain. This ache, during the day, gradually moved backward to base of brain and along the medulla oblongata; relieved by slight motion, increased by large, continued, and more active motion. Slight mental effort, passing from topic to topic, for an instant relieves; sustained effort increases the pain.

Vessels of neck and base of brain full, as if circulation had been cut off by a cord ; the whole back of head, neck, and cerebellum felt congested to the brain and cord-centre; sore inside and tender to outside pressure ; all those parts of the nervous system felt as if double or treble their ordinary size. Eye.

A pain along the line of the optic nerve of the right eye when reading. Conjunctiva very red. While dressing, a dizzy blindness came upon me ; dizziness less on closing the eyes ;

directing attention to the head and exerting the v/ill diminished the dizziness ; at same time, dizziness followed by rush of blood and fulness in the frontal region, soon followed by similar sensations in occipital and basilar regions, soon disappearing.

Face.

A curious sensation of fulness in face, as of pressure from inside out.

Mouth.

Teeth have been very sensitive to cold water, cold air, toothbrush, washing, etc.

Sensation as if the tongue was covered with fur or velvet. Abundant salivation.

Stomach.

During some of the proving, noticeably a day or two previous, and succeeding to the ninth day, took in food with a sort of ravenous haste. Sour eructations, especially an hour before meals, at times rolling up and rumbling all the way from stomach to mouth, but for the most part breaking at the throat-pit with frequent succession.

Abdomen.

Colic about 9 a.m., every morning. * Colic relieved by motion,

or thinking of something else. Sensation of going to have a stool every evening. Sensation of

desiring a stool all day.

Urinary Organs. Burning in the uretnra in passing water. Urine when first

passed was hot, burned the urethra. ° Gonorrhoea, gleet.

Sexual Organs. More amorousness during the primary part of the proving than for years.

Large emissions in the morning. The emissions come on without dreams. Awakened by a large quantity of semen running over him.

Generalities.

An agreeable languor alternates with a pleasant, youthful freshness and vigor of body and mind; feeling of general tonicity

comes on, as during the primary or actionary stage of the proving; voluntary muscular action, as then, so easy as to be almost involuntary ; muscular action increased, but power of involuntary unconscious co-ordination of muscular action impaired; find myself walking fast before I am conscious of it, legs and feet seem to be running away with or from me; my will is called consciously into action to regulate my movements ; feel otherwise unusually well and active. Better in the open air and when moving.

Skin.

The skin is covered, as in leprosy, with large scales, which fall off and leave lasting white spots, which often become ulcers. Skin dry, cracked, scaly and ulcerated, especially where it is thick, as on the hands and feet.

Volume II — Special Therapeutics

In Allen’s “ Encyclopedia of Materia Medica ” is an extensive pathogenesis of Kavakava, but the omission of all clinical cases and therapeutic uses detracts so much from its virtue that I propose to give some account of its general action and use in disease.

Professor Gubler submits in the “Journal de Therapeutique,” 1878, the following conclusions regarding this new remedy:

1. The Kava root (Piper methysticum) possesses two orders of properties; the one cephalic and inebriating, the other diuretic and blennostatic.

2. The Kava drunkenness is sui generis, and does not resemble that of alcohol. Besides, the maceration called Ava is not submitted to alcoholic fermentation, and the preliminary mastication of the root, producing glucose, has no other result than that of giving to the aromatic liquor a sweetish and sugary taste.

3. Among the symptoms that may be denominated acute avaism, the most remarkable and one of the most important consists of a genesiac excitation which has its seat, not in the sexual organs, but in the nervous centres in which the reproductive instinct is vested. There is no priapism, but much erotism.

4. Besides, Kava has the power of moderating the inflammatory condition of the genito-urinary organs, and of reducing or suppressing muco-purulent catarrh of the urethro-vesical mucous membrane, probably through an action at once diuretic and blennostatic.

5. The direct and topical anti-catarrhal action is due to an oleo-resinous, balsamic substance, comparable to the terebinthinates in general use.

6. The indirect diuretic and anti-catarrhal eflects depend in part upon this oleo-resin, but especially on a neutral crystalloid called Kaxvahine, and perhaps upon an unsought alkaloid, the presence of which would account very well for the peculiar drunkenness, as well as for the modification of circulation and secre. tion in the genito-urinary apparatus.

7. This dual action upon the genito-urinary organs assigns to Kava a remarkable efficacy in urethritis during its most inflammatory period. It explains the success of this remedy in cases where the pure terebinthinates have failed, and makes explicable the utility of associating the peppers — notably Cubebs, whose effects are analogous to those of Kava — with the oleo-resin of Copaiba, to secure a cure in acute or intense blennorrhagias.

8. The therapeutic employment of Kava is the more to be commended, as this aromatic remedy is not at all unpleasant, and its use gives rise to no digestive troubles.

Dr. W. N. Griswold, of San Francisco, who has used it largely, gives the following case, illustrating its power in certain diseases :

Case I. Neuralgia. — Miss M. M., aged eighteen ; medium size, dark-brown hair, blue eyes ; health good, except as follows : Has suffered for six or eight

months with a burning pain, covering the surface of half a dollar, changing about in a circular space of four inches in diameter ; centre of the circle about the centre of the sternum ; constipation ; bloated abdomen after noon and evening repast, disappearing in four or five hours ; skin of the face florid, but inclined to scaly roughness.

Pain in the breast worse by eating apples, by sitting still. Relieved five or ten minutes after commencing and finishing eating. Often took food to relieve the pain ; relieved by lying on the back ; pain would disappear as soon as she lay down on the back.

Relieved by diversion of the mind by some new topic, by excitement (of Sundayschool and church exercises), by changing position ; often could not sit five minutes in one place.

Several indicated remedies were used without success. I then directed fifteen drops of Piper methysticum to be placed in half a goblet of water, and two teaspoonfuls to be taken every two hours. The pain, constipation, bloating, and roughness of the face disappeared in five or six days. After ceasing the use of the drug for a week the pain partially returned. Repeated the prescription and the whole annoying group of symptoms again disappeared not to return.

The characteristic referred to in my proving should be noted (i. e., better by diversion of the mind to some new topic) ; also, the relation of the other conditions of amelioration, viz., “ change of position ” and “ excitement ” to this mental characteristic. Other cases forthcoming will show that amelioration by change is a strong indication for the use of this remarkable drug.

Case II. — Was called, June 16th, 1876, about midnight, to visit a man who was about thirty-five years of age ; active habits, sandy-haired, and light complexion. He was suffering from orchitis, dependent on suppressed gonorrhoea. Found him writhing and twisting in bed and out of bed, seeking relief in every posture, but finding none ; irresistibly impelled to move, though gaining no perceptible relief. He had been treated for twenty-four hours by an allopath, with no permanent relief. Supposing the narcotic treatment had been plied vigorously, it puzzled me to know what to do. A case of colic, with similar twisting, writhing, and moving about, had been related to me by Dr. Hiller as having been relieved by Piper methysticum. The case came to my mind. At once I put onehalf drachm in one-half glass of water, and caused him to drink one-fourth of the solution ; in ten minutes gave him two teaspoonfuls ; began to get better. Two or three more doses and the relief was complete. Other remedies were employed to cure the orchitis, as Aeon., Clem., Merc, iod., etc.

Case III. — W. G. W., merchant ; age, fifty ; medium size, full figure, gray eyes and hair. Called, September 18th, 1877, at 12.30 p.m. Complained of an aching, grinding pain in the left side of abdomen, half way between the floating ribs and ilium ; direction, forward and downward ; eructations, nausea, and vomiting of matters without a describable taste ; bowels somewhat bloated and constipated ; pain not relieved nor increased by pressure ; change of position continued ; walked about bent forward ; lay down on his back, rolled from side to side ; got on hands and knees, and swayed forward and backward ; the sweat poured from him all over; relief from these changes but slight, though irresistibly impelled to make them. The agony of this man was so great I felt inclined for temporary relief to inject Morphia; but I bethought me of the case of orchitis, and deter- YOL. xi.— 37

mined to try Piper methysticum. Put two drachms of the first potency in four ounces of water ; gave two spoonfuls ; patient continued still to perform his agonizing gyrations. A few moments later, repeated the dose ; shortly after second dose, he became more quiet, and suddenly exclaimed, “ Thank God, I believe I feel better.” The third dose was given, and within half an hour he left, feeling entirely relieved, the pain having gradually disappeared. The pain evidently involved the left kidney and ureter. I found, several days later, that then he was passing sandy particles. It (Occurred to me that, at the time he was relieved by Piper, a stone of some size might have been passing, and its ultimate discharge might have occurred at the time he was at my office ; and yet, though that contingency should be considered, I shall not soon forget the prompt relief afforded by Piper methysticum.

Case IV. — Called, September 10th, 1877, to see Mrs. B. Two or three weeks previously menses had been suppressed. A lame feeling in right arm, half way between elbow and shoulder, succeeded. This gradually changed to numbness, with a decided dull pain in the same locality. It increased in intensity (three or four days before) until September 9th. It was described as a sharp, aching pain, like jumping toothache, or as successive gusts of sharp wind blowing on an exposed nerve. September 10th, a.m., screaming with the pain, which had run up to the top of the shoulder and right side of the head and face. Shoulder as tender to the touch as a boil. Was called about noon. Supposing it sympathetic with torpid and congested liver, gave Pod.2 and Aeon.2. Some relief followed during the afternoon, but towards night it intensified and became worse than ever. Patient was distracted, exhausted, and horrified at the prospect of another night of anguish ; was tossing about in bed, out of bed, impelled to move continually ; prayed for, but received little or no relief. One-half drachm of Piper methysticum, in two-thirds goblet of water ; drank one-fourth of the solution. Belief followed in a few moments, and patient slept well all night. It was continued the next day, and followed by Podoph. I saw no more of the case, but learned that a dull pain and numbness, even paralysis of the arm, continued, but gradually decreased for weeks. The arm gained its power only when the menses reappeared, some six weeks subsequently.

Piper methysticum will be efficient to relieve agonizing pain, with tossing, twisting, and writhing ; patient driven irresistibly to change position, from which change, generally, little or no relief.

C. C. Switzer, M.D. (allopath), of Macomb, Ohio, gives his experience with Kava-kava in gonorrhoea. He writes to “New Preparations

“ I will endeavor to comply with your request, and report you my experience with Kava-kava for gleet or chronic gonorrhoea. I will give you the result of my worst case, which was surely a severe test. It was of eighteen months’ standing, and had successfully resisted all treatment that had been brought to bear upon it with Copaiba, Cubebs, Cantharides, Chlorate of potash, Iron, Ergot, and injections without number, a good quantity of which I had ordered myself. I had about given it up in despair when I concluded to send an order for a half pound of Fluid extract kava-kava, and give it a trial. The result was most glorious, for

after using about two ounces in forty-drop doses, in a gobletful of water, twice daily, the patient declared himself sound and well, and which has certainly proved to be the case, for he has not felt a symptom of the return of the disease for the last six months, and the organs have full venereal power. He was also relieved at the same time of a troublesome cough that had existed for several years, which led me to think it was a superior tonic for the mucous membranes generally, and to the subsequent use of it in several cases of leucorrlioea, and always with success. I have always used it alone and uncombined with any other drug, so the result must be credited to Kava-kava alone.