Piper methysticum

Volume IV — Appendix

PIPER METHYSTICUM.

" Kava-kava " of Tahiti md other Pacific islands. Nat. Ord., Piptrattit. Tincture is made from root and extreme base of stem.

1, II. Provittgs ami Pouomngi. — i. a. Dr. Gkiswold, set. 42, health good, but

" vulnerable and susceptible. Oct. 16th, 1875, took 10 dr, of jrd dil. 4 times a d.,

"^Q^ising dose to 15 and 20 dr. by end uf week, when he discontinued it. During

"••« time a " toning-up " seemed induced by the drug, so tliat he couW do more

[taJing than formerly, without fatigue and with relish.

.. i. Nov, 20th. — Has taken for j d. past 10 — 15 dr.of 2nddil. No syttip torn* save

"'jSht ienKation of fulness at different parts of brain, mostly in frontal region. At

"«lJajr meal to-day appetite unusually good, but food had not its usual relish or

^^tt, He had taken drug i j m. before eating ; and it had caused dulness, fulness

^d preisure in forehead, with vertigo on elevating head or moving it 10 either side.

J 'ttr meal pressure shifted to lateral and occipital regions, and on lying down

^^^rtiAed to a coa«iderable degree, — not, however, to real pain. It was. relieved by

Movement. At follovfing meals everything was tasteless ; there was sense as if mucous

°*Cmbrane of tnouth and tongue was covered over, and its sensibility lost j tongue

j^lsnot coated. Occasionally, in spite of this, food was taken as with ravenous

^*stc. This e. warm glow over upper part of body, but no marked increase of

"eart't action; unea.sy sensation, as of pressure and weight, on each side of head

*i)ove ear. zind. — No symptoms, though 10 dr. were taken 4 times yesterday. On

rising took ao dr., and within 2 m., while dressing, diziy blindness came on^ less on

closing eyes, and it could be somewhat overcome by will ; it was followed by rush of

blood and tulness, — also pappy taste in mouth, warmth of stomach, and sfight pain in

ibdomcn above umbilicus. These symptoms soon passed away, leaving unusual

languor of brain, 23rd. — No head symptoms after a m, dose dose of 40 dr., and

be telt well all d. Repeated dose at n. 34th. — Latter part of n. sleepless, mind at

work; worn tired feeling before and on arising ; dizziness and frontal pressure even

^^bcn lying in bed. Took 40 dr. Well till e., when from 5 to 9 he felt dizzy, came Bear falling several times j swimming sensation and faintness. At n, brain felt bred; headache at r. temporal region, across eye and bridge of nose, with sense of pressure along sides of nnse haltway to tip (the r, temporal pain is not uncommon to him when fatigued, other symptoms arc), isth, — Last n. took * teaspoonfuls at bedtime. Stupid sleep followed, preceded by heavy pressure on whole frontal part of head ; in after part of n. active vivid dreams, alternated with half-conscioui waking. Awoke with very worn feeling of brain. After getting about took another s teaspoonfuls. A feeling followed as if drug bad descended and impressed lower part o( ".ystem, producing trembling sensation of bowels and lower extremities •nd blood-vessels connected therewith. On going downstairs drug seemed to come through Circulation upward, reaching brain and producing cxhilarative dizziness and dbposition to swing and stagger, as if one were under the influence of alcohol. For

rj h. or more felt talkative and happy. Dizziness soon disappeared, and left a gene> ally " toned.up " condition of brain and nervous system j on commencing to move dizziness returned. Urine this m., when first passed, was hot, and burned urethra |

[w 10 a.m. it was neutral and bland. Bowels, hitherto regular, constipated. Felt all life, vigour, and exhilaration. Took no more medicine. s6tb.'— Reaction

has commenced ; feelings variable and depressed 5 heavy dull temporo-frontal head. ache, increased by reading and thinking ; bowels constipated ; appetite slight sour tructations, especially an h, before mealsy at times rolling up’ and rumbling all the way fom stomach to mouth, but for most part breaking at throat-pit in rapid ‘cesion ; feeling at throat-pit as if something ought to be swallowed, relieved for time by eructation, but soon returns. Towards a, general want of tone and life in all functions; urine hot and over-acid; eructations and feeling at throat-pit +0 disagreeable that he took pulst. to relive, -27th—Headache all last ., with fulness Of frontal region; sleep heavy, with dreams disturbing but unremembered. To-day Aching continues, frontal part of brain seems solid with pain; during d_ this ache gradually moved backward to base of bran and along medulla oblongaias it wat Felieved by slight motion, increased by large, continued, and more active motion, and ‘was affected in like manner by mental exertion; whole back of head and neck felt congested, sore inside and tender to outside pressure, and of double oF teble ordinary size. Gradual improvement in e, Bowels still constipated,» For last 6 a. teeth bave been very schsitive to cold water or ait, and to the brush, 38th— Severe pains and soreness of back of head have gradually gone off, leaving brain (cctebelium) only’ sensitive. The feeling of oversize continues, changing fom frontal to occipital, sometimes also to lateral regions. Agreeable languoF alternates with pleasant youthful freshness and vigour, both of body and mind, Feeling of general tonicity comes on as during primary stage of the medicinal ation 5 voluntary Muscular action, as then, so easy as to be almost involuntary, and co-ordination impaired, Gnds himself walking fase without knowing it legs and feet seem to be Fanning amay with (or from) him, agth—Large and natural stool this m.y fst Toran dr Fale wel tlltowardses whens some Busines anxieties securing” pan came on about middle of forehead, proceeded outward to each side of head, and after retiring at n, followed around sides of head and attacked porterior part, Sensation was not extremely paintul, but was indescribable it was as if parts were evenly compressed in every direetion, especially from front to back. Nervous system was at highest tension, could not sicep fist part of n., and latter pare only at intervals; could le till but a few minutes at a time, it seeming as if head and neck would be compressed to death if I remained quiet long ; hands sought cool places, otherwise ne perceptible increase of heat no thirst, Comstrietive or compressed feeling extended {o chest and stomach as well as to brain, though in less degree, During most of roving eyes felt wide open, and hearing more acute than Ustal. Next d. symptoms Eradually diminished; and from Dec. soto 7th he felt unusually well, On 7th head Ache, Sc. as on Nov. agth recurred, with (2s then) an emission at n,; and the same thing happened every week oF so till end of January. (Hahn. Month, xi, 547.) 2. Dr. HILLER, zt, 9, health good. Dec. 7th, 1876, took 20—25 dr. of a saturated aqueous sol. of P.’meth, about 8am. Tt soon produced flush of heat all over body, dull heaviness across forehead, pain in l.supra-orbital nerve. 8th.—Slept well during n., stool a litle loose this m.. Took another large dose of sol. Soon alter fel dull aching in . shoulder; aching and tingling in le iostep, worse sitting, better in motion ; flush of heat on both checks, pain in r. groin while walking; ‘numbness in r. elbow 5 sharp shooting pains in Intemple. 3 pum, took 20—3o dr of a tinct. made from dry root. Immediately, stitches through i, brain from front to back at intervals, sharp shooting in 1 supra-orbital nerve pain in r, eye when reading. 19, second stool, more diffcuit than in m, Repeated dose, "Thereafter felt lively and wakeful, though unusually sleepy just before. (Had taken during de about $ssof tinct.) gth.——Sharp pain under. patela, making him limp while walking it comes and gocs, and is much worse immediately after taking medicine ; pain abo in reat toe, "At noon tok “slang dove 4 pam aching pan inl ka mhea walking; tongue clean appetite good; feeling lively shooting pain in penis; pain nr. testicle, Sroth-—in severe pan with eight stifiaes in f elbow and 1 Knee ‘4 pam, whole r, arm aches and feels heavy, with slight pains running in all directions through ie; arm fel sore and tired sale heaviness in head, "11th, —Shooting ains in great toe when moving and walking. 12th—Resumed drug, taking la jose at intervals during d. About midday had severe pain above elbow at cr near insertion of triceps. In e, felt invigorated ; no pains of any kind ; more lively and in better spirits than usual ; inclined for work.” 13th—Took another large dase Soon after, pain in I. knee, causing limping ; tingling from I, elbow to fingers as

ft»m galvanic current ; heaviness in forehead ; legs feel heavy from knees downwards, irhile walking. 3 p.m., felt somewhat drowsy and stupid, with dull frontal headache, during whole attemoon and e. 14th. — Has been annoyed with aching p»Ua. in r. wrist, worse when writing. This continued all next d. also. i6th. — Craunpy pain in stomach lasting 4 h., relieved by presMng stomach against edge of table, and by motion; aching in wrist began at 10.30, with soreness and slight pricJcling pain running up arm to elbow. Pain had gone by i p.m. ; dull aching at intervals in r. frontal eminence, better in open air and when moving. No further tynaptoms. (iM</.,p. 618.)

1. «. Dr. M. A. Wolff took tinct. 3 times a d. for about a month, doses from 6 dr. to 3 and 4 teaspoonfuis. ist d. — Soon, uneasiness in head ; after i^ h., aching m vrhole L arm, and flushing heat in 1. hand, which in time changed to aching in middJe and third fingers; after 4 h., pain in and joint of 1. thumb; after 5 h., ^Sue in both thighs, as if unable to stand on them, and pain in 1. toe ; after g| h., ■e'ttache and sleepiness, so great that he could hardly attend to a patient ; very drowsy all d. and d. — Great frontal headache all d., at 8 p.m. ache especially over eyes and deep-seated ; very hungry at midday, but unable to eat much either then ■"' Q e. ; teverish heat in 1. auricle and 1. hand, continuing up to lath d. ; at n. •^**tion as if tongue was covered with fur or velvet. 3rd d.— Went through work with uncommon cheerfulness and ease ; aiternoon nap dreamful ; woke with great ^yncks of mouth and heavy perspiration. 4th d. — Sensation of desiring a stool all d. ; ^jinung in urethra on micturating ; heaviness in upper chest behind sternum, as if filled with wind that cannot be eructated ; pain in 1. knee when walking ; pain in 1. '''^> »t outer and under border, foot itself feeling cold, with pain in r. big toe ; "^fuloess during usual sleeping.time ; at n. fragmentary sleep from is.30 to ^* »>ni., with varied and exciting dreams. Got up at 4.30 ; did excitedly all kinds ot UQusual ofice work ; slept soundly 1.30 to 2,45 p.m. ; curious, nonsensical, wild "**•»». 6th d. — Pain in 1. foot and toe. 7th d. —Continual desire for stool ; very ^'"^^ and hard stool (on a previous d. it had been large and hard) ; pain in joint of '' '«umb, aggravated by pressure, and in toe of 1. foot. 8th d. — Immediately after ist doac, pam in frontal part of head ; pressure behind eyes ; singular pressure in'

iive pain in tront ot head, especially

eyes hurts ; formidable appetite at

a recurs, intermittently, ror several

drowsiness during d. ; a painful

tunap^ tiireatening to become an abscess, has appeared on r. forehead, just above inner

•■••llsuii of r. eye. 9th d. — Swelling is still there, but redness and pain have gone ;

"'*viiic in legs J pain jq r, foot ; in spite of lateness and tatigue could sleep little at

^' >oth d. — ^Lump still swollen, but less painiiil. 5 p.m., frontal headache, just

• I ^c Kyes, with soreness of back about and dorsal vertebra — this last felt still, but

y OQ pressure, at 11^5 ; transient pain in 1. knee; felt lazy and drowsy, in e. quite

?*^^ Out; teverish feehng in face and hands (especially 1.). From nth to 13111 d.

'"^t* on forehead gradually disappeared ; bowels were, as heretofore, costive ; on

. ^^ n. a very vivid dream of a fire. 14th d. — Pain and heat in whole r, foot and

X- '^**«»» of 1. hand, at 1 1.30 p.m. 1 5ih d. — Pressure in head, back of eyes ; weariness

^^^'^^Ver extremities all d. ; pain in r. calf; midday sleep very heavy, much drowsi-

J** *fter it, 16th. — Pain in calf keen to-day. 17th d. — Slept a great deal during

_L . *Sth. — ^Frontal pain, 1. side, in e. ; desire for stool all d. ; at noon pain in

S^r<**>*» *'f *■' ""> '° *•» while walking, in I. foot also. 19th d. — E., frontal

^r^^^Ctoe ; curious sense of fulness in face, as of pressure from inside outwards ;

^jjj?**ch bloated ; disagreeable dragging pain in whole 1. arm ; pain in r. wrist and

j(-j^5 *«id in toe of 1. toot ; still frequent urging to stool, aoth d. — Forced a hard

^^^» Mrhich caused prolapsus ani ; frontal headache at 9 a.m., worse at 3 p.m. ; slept

^1^^ S to 6, hoping to sleep it off, but at 6.30 it was so severe as to compel him to

j^^** X&uz vom., which aggravated, and then bell. : it was very bad before going to

2^C* «t midnight, but had disappeared when he was called up at a a.m. ; it came on

li^*** %t»td., but had gone when he woke on »ind d. On this last d. pain in r. great

jj^j^^'^^ tjoon j heat in 1. hand, fingers, and ear, 10 a.m. »4th d. — Pain over eyes,

l|j^^*i«jg from r. supra-orbital region; restless n. ajth d.— Headache, with

?^^^»« in upper part of orbits ; pain in both calves, after bathing ; many uneasy

^^"^^iona during a. ; feverish heat at 9 a.m. a6th d.— In m. great pain in lower

part ofr calf, moving to tendo Achillis by 8 am., and changing to. sole at 4 p.m. at 7 it was scarely felt (on waking had felt a keen stinging stitching pain at end of 1, toe, lasting a few m.); small painful swelling at lower corner of I. car, which was less painful next d., and harder on 8th d, agth d.—Two very large stools, after first frequent colicky pains and distressing sense of fuiness in bowels. —soth d.—Very weak in lower extremities, pam, ; more so (with great drowsiness) on 3st, and weak. ness stil felt on 33rd (when, however, mental condition was one of satisfaction and hilarity) and 34th d.—on latter also chilliness in e, On 3gth d. burning sensation in rectum returned, and there was pain in 1 foot. On gist d. felt weary and completely broken down in lower extremities, On goth d, he notes:—" The only symtom that has troubled me for some d. past is the sensation of going to have a Stool every e." From agth d, stools were large and soft, and inclined to be loose,

'. Four weeks after last dose W. took 2 doses of § dr. of a strong tinct, Next d. there came on most excruciating pains in r. arm, as if in marrow; “location of pain changes in whole length of arm, from shotlder down to. finger ends,” hand several times felt as if paralysed, so that he could hardly hold a pen. pain at times s0 distressing as to make him almost frantic. At same time pain in r. great toe, also (at 6 pam), less severe, in and around r. fibula ; at 9 p.m. pain left toe, but came on in +, hand, especially in metacarpal bone near little finget, Nothing more is said of these pains tll sth d. (the above being counted as and), when there is recorded=— “At Fam in bed, pin in lower par of t arm unbearable; hand fel so weak I can hardiy Use it to grasp anything; took bryon., and fell asleep about 2.30; at ¢ ‘woke with enact the same symptoms, when bry. was repeated with Hike result OR getting up at 6 pain returned in fll strength ; at 81 took thus, ia about an h, after Which all pain in arm and hand had ceased, though that in r, great toe continued pretty bad, and only wore off gradually.” Besides above, there was on “and 2" a Second stool, p.m., natural in character, but enormous in size; and at $.30 putty pain deep in I. eye, as if eyeball would be pressed out—it’ had ceased by 6. CALLEN'S Engclpiedia vil 543.)

1. A strong infusion produced “stimulating and sedative” effects, lasting for 24h, and leaving subject in profuse perspiration. (MoRsox, in Ibid.)

2. 4 In asmall dose, kava isa toni stimolating " beverage, producing an agree. able excitement, and affording support against great fatigue, In increased doses this root determines an intoxication of a sorrowful, silent, and sleepy character, com. pletely different from that produced by alcoholic drinks, When taken concentrated this drunkenness may be imstantaneous 5 with the ordinary dose it occurs about 20 im. after ingestion, It does not last longer than 2h, but if a person only takes it ‘occasionally the effects may continue 12 hy oF, when taken at intervals of some for 6h. When made from the root grown’in damp soils, the drinker rema plunged’ in a deep torpor, and scems irritated by the least noise, The habitual drinkers of Kava take if 6—8 times ad, but then a nervous trembling seizes them, and they can searcely lift the cup to theit lips, A peculiar skin disease results from its daily use.

2 fa old drinkers the conjunctive are very red; vsion is obscured ; teeth are of ‘deep yellow colour; skin is dry, scaly, cracked and ulcerated, especially where it is thick, as on hands and feet there is complete emaciation and decrepitude. (Cuzenr, from Ibid.)

6 The effects are particularly pleasant. An irresistible sleep seizes you, and lasts 12—24 h,, oF even longer, according to individual temperament, Often, when dos is too get o too small, Seep doesnot follow, hatin spleen intoxication, accompanied by fantastic ideas and a strong desire to skip about, though one cannot fora moment hold himself on his los. ele those spmptors for Goh the Sst time I tasted this Polynesian liquor. In habitual drinkers the body becomes emaciated ; and the skin is covered, asin leprosy, with lafge scales, which fall off and leave lasting white spots, which often become uleers, (REMY, from Ibid.)

1. a. LEWIN has experimented. with a resin which appears to possess all the properties of the root. ‘Taken by the mouth it causes burning and saltvation, Even during the burning, but especially afterwards, there occurs numbness in all parts which have been in contact with the drug. If minute quantities be placed upon the conjunctiva, it and the cornea become completely insensible to irritation, pupils

ing their tormal sie and variability under light.

b. In the drinken of kava, he sutea, consdousnets and reason are in no wiw ikered ; the mental faculties are even said to be sharpened, and bodily exertion to be more easily borne. After a time there occurs a condition of happy carelessness, a dreamy consciousness prevails, the limbs become languid ; gradually the will loses its power over the muscles, co-ordinate movements cannot readily be executed ; the drinker lies down, mav gradually fidl asleep, more often falls into a somnolent, soporaae state. When taken in excess there is intense nausea and headache ; paresis of extremities, nervous trembling and somnolence quickly supervene. {Berl. Him. WaektMsekr^ Jan. 4th, 1886.)

III. Ej^triwuMtt em ammtdt.—t. Lbwin found that, injected into the subcu> tmneous cellular tissue of cold- or warm-blooded animals, the resin produced local aaaeathesia, the part becoming insensible to all irritants, and look me ischannic. The constitutional symptoms resembled those produced in man. The paralysis induced is a central one. It reaches first the motor spinal ganglia, then the sensory, and finally, perhaps, those of the brain itself. (JbttL)