Geranium maculatum

Volume I — Special Symptomatology

(Cranesbill.)

Botanical Description. — This plant is also known by the names of Cranesbill, Geranium, Spotted Geranium, Alum root, Crowfoot, etc. It has a perennial, horizontal, thick, rough, knobby and fleshy root, with short fibres, and sends up annually one or more erect, angular, or round, retroversely pubescent, herbaceous, dichotomous stems, from one to two feet high, and of a grayish green color. The leaves are spreading, hairy, palmate, with three, five or seven deeply cleft lobes, two leaves at each fork; the lobes are cuneiform and entire at the base, incisely serrate above. The radical-leaves are on long petioles, erect and terate ; the leaves at the top are opposite and subsessile, and those at the middle of the stem are opposite, petiolate, and generally reflexed. The stipules are linear or lanceolate. The flowers are large and generally purple, mostly in pairs, on unequal pedicles, sometimes umbelled at the ends of the peduncles.

Officinal Preparations. — Tincture or trituration of the root.

Analogues. — OMic acid, Tannic acid, Hamamelis, Plumbum, Ratanhia, Rheum.

[The tincture should be made with water and alcohol, equal parts. It contains 136 grs. of Tannic acid and 120 grs. of Gallic acid in 7,000 grs. of the root.]

(No provings.)

° Abnormal discharges from mucous surfaces, after the inflam

mation has subsided. 0 Catarrhal ozcena; (used topically). 0 Intestinal catarrh, chronic; (internally). 3 Leucorrhoea, vaginal; (topically). 0 Hemorrhages from ulcerated surfaces.

° Diabetes and Bright's disease.

0 Aphthous stomatitis and mercurial salivation.

0 All morbid fluxes connected with relaxation and debility.

(Rafinesque.)

° Haemorrhage from the kidneys; equal to Gallic acid. {Hale.) ° Catarrhal secretion, profuse, from the mucous membrane of

the fauces and posterior nares. 0 Chronic diarrhoea and dysentery.

[When used for the above named conditions it must be used in material doses, generally topically as well as internally, because the drug would cause such disease by its secondary action. Its (opposite) primary effects would call for the high attenuations. (Hale.)]

Volume II — Special Therapeutics

This indigenous species known under the common name of “ Cranesbill,” from the peculiar shape of the seed-vessel, is used by the country people as an almost universal remedy for diarrhoea and other fluxes. The root contains nearly thirty per cent, of Tannin, and its curative action is doubtless due to the presence of that agent.

Homoeopathists have rejected — rightly or not — all the socalled astringent medicines for the cure of abnormal discharges.

It is a question whether it is right for us to throw out such medicines.

Eclectic physicians claim that it not only cures diarrhoea, but that it “leaves the mucous membrane in a moist, healthy condition,” i. e., normal.

As I shall speak of several similar medicines during my lectures, permit me to quote from the second edition of my “ New Remedies

My attention was first called to the remedy by observing the promptitude of its action in certain cases of diarrhoea, from loss of tone in the mucous membrane of the bowels, or in the discharges which continue after the inflammatory stage o'f a dysentery. In such instances I have known discharges to cease under the action of Geranium when they had resisted the careful and persevering use of the ordinary homoeopathic remedies. One fact arrested my attention, namely, that it was rarely used by intelligent laymen or physicians (eclectic) until the inflammatory conditions had passed away ; and that if used too soon, it was very sure to aggravate the conditions. In this respect it acted very much as does Rheum in the hands of allopathic physicians.

These observations led me to inquire whether there was not something in the medicinal action of astringents that would account for this favorable action under certain circumstances. In other words, could not their curative action be made to accord with the law of Similia, and with the law of dose, which is the necessary result of that law.

To illustrate the curative action of Geranium, I here present several cases, which were treated by me or came under my observation :

Case I. — A gentleman had been troubled for a long time with a copious secretion of mucus about the fauces, obliging him to constantly “ hawk ” and clear the throat, much to his annoyance. The condition originated in an acute catarrhal attack, which occurred several months before. An examination showed no traces of present inflammatory action ; the mucous membrane looked pale and relaxed, and large drops and clots of mucus adhered to the fauces. I used for a reasonable time Mercurius iod., Hepar sulphur, Hydrastis, and several medicines which seemed indicated, but no curative effect was observed. I then prescribed Geranin in the first decimal trituration, two grains to be taken three times a day, and a weak lotion of the same remedy, and as a gargle. In a week the patient reported himself cured.

Case II. — A lady, aged 45, had been ill with chronic diarrhoea for nearly a year. The evacuations were usually watery, with but little pain, contained undigested food, and occasionally traces of mucus. The number of evacuations, daily, varied from four to fourteen. A good many medicines were used, in high and low potencies, but with no permanent curative results. Arsenicum and Sulphuric acid were the most useful. Finally, she became very anaemic, debilitated, and so dispirited that her condition became critical. On the suggestion of a friend who had been cured with the Cranesbill, and with my permission, she commenced the use of the root in infusion. It was prepared by pouring upon one teaspoonful of the powdered root a teacupful of hot water. This, after standing a few hours, was taken as follows : one-third of the quantity every six hours. I carefully watched the case, allowing no other remedy to he taken, and permitting no change in her usual diet. After the third day the evacuations became less frequent and profuse, until at the end of a week or ten days they had become normal. At this time I suggested that the medicine be discontinued, which was done, but resumed again in two days, as relaxation of the bowels recurred. The remedy was continued in gradually decreasing doses for a month, when it was discontinued, and she has since had no return — now two months.

Case III. — Was one of chronic, exhausting leucorrhoea, of a vaginal origin, and attended by no ulceration or abrasion ; a mere passive discharge from a relaxed mucous surface. Geranium, ten drops, four times a day, was prescribed, with injections of the same medicine, prepared by pouring one pint of water upon two drachms of the powdered root ; the whole to be used during the day — half in the morning, and half in the evening. In two weeks she reported herself as cured.

These cases, together with my observations of its successful use in many other cases, has prompted me to offer the following suggestions in lieu of a thorough proving, which I have not been able to obtain.

It must be remarked by every observing homoeopathic physician, that while the opposite school estimate very highly the “ astringent ” medicines, they are but seldom used in our own school.

Let us now proceed to examine into the nature of the action of the so-called “astringents,” in order to ascertain if they can be used in a practical manner in accordance with the law of “ Similia.”

“ Astringent ” agents are taken from the vegetable and mineral kingdoms. The vegetable astringents comprise Tannic acid, Gallic acid, Kino, Quercus alba et rubra, Rhatany, Statice, Geranium maculatum, Haematoxylon, Epiphegus virginiana, Trillium, Rhus glabrum, Ribus, Potentilla, Myrica cerifera, Matico, Uva ursi, Ohimaphila, Erigeron, Erechthites, Hamamelis, etc.

Among the mineral astringents are Sulphuric acid, Plumbum aceticum, Ferrum sulphuricum, Alum, Zincum sulphuricum, Cuprum sulphuricum, etc.

In the Materia Medica of the opposite school, many medicines are mentioned as astringents which do not belong to that class, but are more properly “escharotics,” namely, Argentum nitrieum, Kreosotum, and Mercurius corrosivus.

We will first examine the action of astringent medicines as explained by allopathic authors.

It would occupy too much space to give the opinion and explanation of every writer on Materia Medica. We will therefore quote from Dr. Headland, who seems to embody in his chapter on “Astringents” all the most important speculations in vogue in his school as to their physiological and curative action.

He defines astringents in a “ General Proposition,” as medicines which “ act by passing from the blood to the muscular fibre, which they excite to contraction .” He remarks :

They do not necessarily act in the blood, although many litem at ics are also astringents. They do not pass from the blood to the nerves. They do not always act by passing out of the body through the glands. As neurotics act directly on nerves, so these act directly and especially on muscular fibre. They cause this to contract, whether it be striped or voluntary, or of the involuntary or unstriped kind. Their action is more readily understood, because it can actually be seen. It takes place out of the body, or in the body — externally or internally. Nearly all astringents have the power of coagulating or precipitating albumen. By virtue of this power they are enabled to constrict many dead animal matters. They affect fibrinous tissues in a similar chemical way. But they seem to effect a further dynamical influence over living tissues, which possibly depends in some way on this chemical property. This dynamical influence is, as I have said, to cause the contraction of muscular fibre. By this all their operations can be explained. Taken into the blood in a state of solution, they pass through the walls of the capillaries to the muscular tissue, by inducing the fibre of the involuntary muscle to contract. Astringents may brace the system and simulate the action of tonics, but as the action of voluntary muscle is short and brief, it requires for its maintenance continual excitation ; and unless the medicine is thus continually repeated, the tonic effect subsides. But astringents further contract involuntary muscles ; this contraction is slower, but more durable and important in its results. Unstriped muscular fibre exists in the middle coats of arteries, in the walls of capillary vessels, in the lining of the ducts of glands generally, in the substance of the heart, and in the stomach and intestines. Astringents are irritants and poisonous in large doses. But in small doses they constrict and stimulate to a healthy condition those tubes that contain in their coats

the unstriped fibre. By diminishing the calibre of the capillary vessels generally, they promote health and counteract a lax state of the system. By the same action on the extreme vessels they prevent haemorrhages. By constricting the ducts of the glands they diminish the secretion of those glands, because denying it an exit. By acting on the stomach and intestines they are able to give them tone, to diminish their secretions when excessive, and thus to promote digestion.

The above may be said to embody “all the accumulated wisdom” of the old school in relation to the action of astringents. To the homoeopathist it is vague and unsatisfactory. Let us see if we can get any light from further investigations.

We will not stop to consider the chemical action of astringents, either on dead tissues or on albuminous substances. Such action may be termed chemico-mechanical, and does not come within the scope of this paper. Dr. Headland seems to think that, aside from the above mentioned, astringents have another method of action, which he would imply was the chemico-dynamic force. With a strong leaning to a belief in the presence of a dynamic power in drugs, not recognized by his own school, Dr. Headland cannot get rid of a certain materialism, which prevents him from accepting the great truth, that all medicines act in a dynamic manner when once taken into the circulation, or even when brought in contact with nerve-matter. I agree with Dr. Headland, however, in his “ General Propositions,” that astringents do act by passing from the blood to the muscular fibre, which they cause to contract. But is this the only way in which astringents act? Must they pass into the blood — be carried through the round of the vascular system — before they are brought in contact with the muscular fibre of the coats of the stomach or intestines? When applied to the lax and debilitated mucous surfaces discharging an unhealthy secretion, is it necessary that the medicine must pass into the blood, and through the circulation, before it acts upon the mucous and muscular tissues of the organ or surface to which it is applied ? Such a roundabout way is not necessary. The mere contact of a medicinal substance with the diseased tissue, for the morbid condition of which it is the remedy, suffices to effect the cure of that condition. It may be taken up by the absorbents, or enter the capillary system (if applied to the skin), or affect, by its dynamic force, the terminal nerve-filaments.

When brought in contact with such tissues or fibres the astringent principle or dynamic force residing in such principles causes them to contract. This contraction of muscular tissue implies more than at first thought appears. Not only does muscular fibre exist in the walls of all hollow organs, the bloodvessels, etc., of the body, but the microscope has demonstrated that it exists in the fungiform papillae of the tongue ; in the excretory ducts of the perspiratory and other minute glands. It has even been maintained by some that the cilia of the epithelium was due to the presence of muscular fibrillse. The astringent dynamic force may therefore modify the physiological action of the minutest as well as the largest structures of the body, and morbid action, wherever muscular fibre exists. In this way it may unnaturally contract the muscular coat of stomach and intestines, the bloodvessels, etc., causing perturbed action of the organs of digestion and circulation. By acting on the excretory ducts of glands it will seriously modify the secretion from such glands, render membranes dependent on such glands harsh and dry, and check the secretion of urine and perspiration. When the medicine is applied locally, either in fluid or solid form, it dries up the natural secretions of the surface, and deprives it of some of its nervous sensibility.

PATHOGENETIC ACTION OF ASTRINGENTS.

1. Primary Action. — Astringent medicines act on the muscular fibre of the intestinal tract, bloodvessels, excretory ducts of glands, skin, mucous membrane, in all of which they cause contraction with a diminution of secretion.

2. Secondary Action.- — The loss of tone, the laxity, and undue secretion which follow the primary effects of astringent medicines, is as much the specific effect of these drugs as the latter. Says Dr. Headland : “ But as the contraction of voluntary muscle is short and brief, it requires for its maintenance a continual excitation, and unless the medicine is thus continually repeated the tonic effect subsides.” This is the case also with involuntary muscle. The contractile effect of the medicine ceases because the irritability of the muscular fibre is destroyed by the large quantity of the drug, or its frequent repetition. The secondary effect, then, of an

astringent is to cause a loss of tone, and a deficiency of normal irritability in the muscular fibre which it affects.

The loss of tone extends also to the particular mucous surface or surfaces for which the drug had a special affinity.

Hence, as a result of the above-named conditions, there will exist distension or laxity of muscular organs, colliquative sweats, morbid discharge from glands, haemorrhages (passive), abnormal and profuse secretion from mucous surfaces (blennorrhoeas). The secondary action of astringents is often observed in the persons of patients under allopathic treatment for diarrhoea and other abnormal discharges from mucous surfaces. While under the first influence of the astringent medicine the discharge is checked, the mucous membrane becomes dry, and its substance more firm. But the reaction is sure to occur, unless the vital force maintains the equilibrium, and the discharge reappears in a more aggravated form, with a corresponding laxity of the mucous tissue. Alum is much used for relaxed uvula, and by singers to “strengthen the relaxed tissues of the throat.” But Mialhe observes that the Alum used so largely by public singers maintains the vocal parts in a state of “ flaccidity,” instead of constringing them. The allopaths are well aware of this secondary action of astringents; for they caution the practitioner against using these medicines in too large doses, or a too long-continued use of small doses. The reason of this secondary relaxation is evidently found in the fact that the dynamic action of astringents upon muscular fibre is not by means of transmitted nerve force, or by an increase of vital force, but is more akin to mechanical irritation, an irritation which wears out the irritability of muscular fibre sooner than any other.

CURATIVE ACTION OF ASTRINGENTS.

The question, How does an astringent medicine cure a diseased condition? can evidently only be answered in one way. Astringents, like all other medicines, cure diseases and morbid conditions and symptoms which are similar to those caused by this class of remedies. All medicines cure by virtue of the law of Similia, and astringents are no exception. But it must be borne in mind that

we cannot assert, as do the authorities in old-school therapeutics, that one astringent may generally be substituted for another. In fact, their recommendations belie the general rule which they try to establish. By referring to any work on practice, it will be noticed that a certain astringent is recommended for nightsweats, one for diarrhoea, another for profuse mucous discharges from the vagina or urethra, and still another for haemorrhages.

The truth is, that each medicine belonging to the class “ Astringentia” is a distinct entity, having, perhaps, some properties in common with the rest, but at the same time possessing some qualities which cause it to differ essentially from all the rest of its congeners. To meet the demands of a scientific materia medica, each individual of the class should be separately proven, in order that we may see at a glance in what respect it differs from its analogues.

In the homoeopathic Materia Medica we have the pathogenesis of very few astringent medicines. They are Alum, Tannic acid, Ferro-sulphuricum, Sulphuric acid, Plumbum aceticum, Uva ursi, Gallic acid, Rhatany, Zineum sulphuricum.

By referring to provings of these medicines, it will he seen that the primary and secondary symptoms of each are mixed together without any attempt at arrangement. If the physician did not possess some knowledge of the physiological effects of the drugs, our provings would give him no correct idea of the manner and order in which such symptoms were evolved.

So too in the “clinical indications” prefixed to each remedy, the same want of order is manifest. They are recommended for diarrhoea and constipation, for spasms and paralysis, and so on, leaving the student in a maze of uncertainty, wondering how a medicine can be used for conditions directly the opposite.

Unless we take cognizance of the primary and secondary actions of medicines we cannot reconcile those apparent discrepancies. Those who are familiar with my teachings in relation to law of dose, as based on the dual action of medicinal agents, will readily understand the following propositions, as explanatory of the curative action of the class of medicines under consideration :

Proposition I. — All astringents primarily cause contraction of muscular fibre in some portion of the body, together with a diminution of secretion from the glandular and mucous tissues.

Therefore, astringents are primarily homoeopathic to similar conditions, occurring as the results of disease.

Proposition II. — All astringents cause secondarily a diminution of tone and laxity of muscular fibre, with a similar condition in glandular and mucous tissues, and consequent increase of secretion even to colliquative discharges.

Therefore, astringents are secondarily homoeopathic where such conditions occur in the organism, and have been produced by the primary conditions before mentioned.