Ptelea trifoliata

Volume I — Special Symptomatology

(Wafer Ash.)

Botanical Description. — This plant is also known as Wingseed, Sfawbby trefoil, and Swamp Dogwood. It is a shrub from six to eight feet high, with leaves trifoliate, and marked pellucid dots: the leaflets are sessile, ovate, short, acuminate, downy beneath when young, crenulate, or obscurely toothed; lateral ones inequilateral, terminal ones cunate at base, from three to four and a half inches long, by from one and a quarter to one and a half inches wide. The flowers are polygamous, greenish-white, nearly half an inch in diameter, of a disagreeable odor, and disposed in terminal corymbose cymes. Stamens mostly four; style short; fruit a two-celled samara, nearly an inch in diameter, winged all around, nearly orbicular. It is common to this country, growing mostly west of the Alleghanies, in shady, moist hedges, and edges of woods, flowering in June.

Officinal, Preparations. — Tincture from the bark with strong alcohol ; dilutions; triturations from the tincture.

Analogues. — Arnica, Bryonia, Chelidonium, Nux vomica, Rhus.(?)

Mental Sphere.

Great languor and indisposition for either mental or physical labor.

Malaise of body and mind; desire to lie down and think of nothing at all.

Inability to concentrate the thoughts, they seem to be chasing

each other through the brain. Complete incapacity for mental exertion, with headache. Fretful and irritable at very slight cause. Compelled to give up any attempt at exertion in p. m. Performed his duties in a perfunctory manner. Great mental confusion.

Extraordinary weakness of memory; inability to read names.

Peevish, irritable feeling, and intolerance of noise.

Marked forgetfulness, with increased headache, and disposition to hurry when writing.

Confusion of thought, with hurriedness of manner, forgetfulness, with mistakes in writing.

Sick and faint; desire to shrink from every mental work.

Dull and stupid feeling. Aversion to society; a wish to be let alone. Annoyance and irritation from ordinary conversation.

Head.

Pressive feeling at the base of the brain, with nausea, closely resembling the Ipecacuanha symptoms: "Headache, as if the brain and skull were bruised, penetrating through all the bones, down to the root of the tongue, with nausea."

Frontal headache all day, pressing from within outwards.

Pressive pain in the frontal region, extending to the root of the nose, as if a nail were driven into the brain (left side).

Piercing pain shooting through the temples, with increased headache and nausea.

Splitting headache, with nausea.

Piercing pain in the brain, with giddiness, and severe aching

pain in the stomach. Headache after dinner, aggravated by mental exertion. Sharp, cutting pains through the front of the brain, alternated

by pressure.

Racking frontal headache, with heat of the face and head, and

great desire to hurry his business. Heaviness in the occiput, with a gloomy feeling in the fore

head.

Heavy, pressive frontal headache, worse at night, piercing from within outwards, and aggravated by stooping.

Stunning, piercing headache (a similar one was cured by Rhus).

Persistent headache, with sharp pains shooting from the frontal to the left parietal region.

Frontal headache, aggravated by moving the legs and by noise.

Sudden pressive pains in the temples; worse in the right.

Fine, neuralgic pains in the temples; worse in the right.

Constant dull headache, aggravated by going up stairs and by walking.

Sharp, darting pain over the left eye, extending deep into the brain.

Throbbing pains over the eye, from right to left. Shooting pains in the head before rising in the morning. Throbbing pain over the temples, from left to right.

Severe throbbing headache on rising, with great weakness. Dull, frontal headache, with depression and sour stomach. Headache, intermitting with pain in the hypogastrium, dizziness and nausea. Pain in the left side of the head and right side of the neck. Headache over the eyes.

Sudden pressive pain in the temples, as if they would be pressed together, or as if the right would be pressed to the left (frequently occurring during the proving).

.Frontal and occipital headache; headache while reading.

Giddiness, with continued vertigo, and increased abdominal tenderness.

Giddiness of the head, when rising in the morning, and when waking, reeling as if intoxicated.

Giddiness and vertigo in the forenoon, so as to necessitate a recumbent posture.

Severe attack of vertigo, with increased headache, and aggravation of all the symptoms.

Sudden giddiness, with faintness on turning the head; vertigo aggravated by even a gradual turning of the head.

Vertigo and nausea aggravated by rising to the feet, also by walking; inability to stand without the aid of a chair.

Vertigo and confusion too severe to permit letter writing.

Sudden attack of vertigo, lasting a minute.

Everything seemed to be in a violent agitation.

Eyes.

Twisting of the eyelids. A shooting pain over the eyes, when startled. Nervous twitching of the upper lip, extending to the left eye. Nervous pain, extending from left arm to left eye. Rolling the eyes upwards aggravated the frontal headache. Pressure over the eyes, aggravated by lifting the eyebrows. Heavy fullness over the eyes; pain in the eye; pupils contracted.

Painful sensitiveness to light, with irritability.

Ears.

"Ringing in the ears, with slight giddiness.

Sensitiveness to sounds; impressions of sounds last heard continue for a long time.

Intolerance of noise and of loud talking; annoyance at even ordinary conversation.

Easily startled at usual sounds

Pain in the right ear, and behind the right ear.

Intense throbbing pain in the ear, worse on motion.

Itching of the right ear, with inflammation and swelling, terminating in white blisters on a red base, discharging copiously a watery fluid.

Face, etc.

Burning heat of cheek and face.

Heat of head and face, especially of the forehead.

Yellowish face, with dry, hot skin.

Sickly paleness of the face, especially around the eyes.

Pressure at the root of the nose.

Mouth and Throat.

Feverishness and dryness of the lips, with thirst (p).

The lips cracked and sore, notwithstanding an abundance of saliva (s).

Burning, prickling sensation of the mouth and tongue.

Much dryness of the lips and tongue, with hawking of mucus

from the pharynx. Great dryness of the mouth and head. Increased secretion of saliva of a saltish or bitter taste. Drooling in the night, wetting the pillow. Fine prickling sensation over the whole surface of the tongue. Tongue coated with a yellowish fur ; the papillas red and.

prominent.

Tongue dry and brownish-yellow or light brown.

Tongue swollen and furred, white.

Tongue coated yellow along the centre and base.

Tongue feeling as if scalded, or as after taking Aconite.

Tongue inflamed, but not swollen.

Dull, aching pains in all the teeth.

Teeth all feel sore, with increased secretion of saltish saliva. Pain in the right molar teeth; first lower, then upper.

Teeth feeling elongated, or as if something was crowding them apart.

Pain when moving the jaws. Roughness of the fauces, with nausea. Sensation as of a foreign body in the larynx. Slight vertigo, with a choking feeling in the pharynx (in evening).

Soreness and inflammation of the fauces, soft palate and uvula

(worse on right side). Throat ulcerated and tongue inflamed (right side). Distressing feeling of emptiness in the oesophagus. Slight burning in the throat and stomach, with hiccough. Sense of obstruction in the larynx, on waking. Great hoarseness; inability to speak aloud.

Taste and Appetite. Unusual hunger; craving for acid food.

*Voracious appetite; food had not its natural taste; with pain

in epigastrium following every meal; despondency. Appetite poor; but little appetite and no thirst. Bread seemed tasteless; all other food tasteless or unnatural. * Great repugnance to animal food, and to rich puddings, of

which he is ordinarily fond. {Hale.) Great repugnance to butter and fatty foods; even a small

quantity aggravated the epigastric pain. (Ih.) Disgust at the sight or smell of food, especially of roast beef. The taste of the medicine continually returning in gusts to the

mouth, with a feeling as if vomiting would relieve. Very little appetite, with great repugnance to butter. Eructations tasting of the medicine, with persistent nausea. Eructations tasting of rotten eggs; sour eructations. Frequent bitter taste in the mouth, with dryness. Taste of brass on rising in the morning. ° Dyspepsia, chronic, obstinate (many cases). (Hale.)

Gastric.

Nausea and retching, with increase of frontal headache; aggravated by speaking. Severe nausea, with efforts to vomit for two minutes.

c Sensation of goneness, or an empty feeling in the stomach after eating.

Nausea, with distress in the umbilical region, and headache.

Increased nausea, with heat of skin and profuse perspiration on the forehead, after dinner.

Nausea and vomiting, without relief from the frontal headache.

Persistent nausea and vomiting, with giddiness and unsteadiness of the legs; aggravated by walking.

Awakened at one a. m., by a piercing pain in the stomach, as of a weight, aggravated by motion and pressure, accompanied with eructations of a bitter fluid, with deathly nausea, confusion of head, and sweat on the forehead. (The attack lasted for hours.)

Eructations, which almost caused emesis (after stool).

Griping in the epigastric region, with dryness of the mouth, yellow-coated tongue, and a bitter taste.

Eructations of bitter fluid, with deathly nausea.

Colic, with emission of flatus and borborygmus.

° Chronic gastritis; a constant sensation of corrosion, heat and burning in stomach, with vomiting of ingesta, constipation and afternoon fever. (P. H. Hale.) 0 All the gastric symptoms were much aggravated after meals.

Liver, etc.

Constant feeling of weight in each hypochondria, when walking (dragging pain).

Sharp, cutting pain in right hypochondrium, aggravated by a deep inspiration (while in bed).

Occasional pains in right hypochondrium, shooting downwards.

Dull, heavy pain, apparently on the convex surface of the liver.

• Liver perceptibly swollen and sore on pressure, causing a dull, aching pain, with stitches.

Awakened by a dull, heavy pain in the liver, relieved by lying on the right side. A feeling when lying on the left side as if the liver was dragging on its ligaments.

Heavy, aching pain in the liver, with deficient appetite.

Sharp pains in the right hypochondriac and the gastric regions,

caused by rapid motion. Awoke with hard, aching distress in the base of the liver.

• Hepatic and gastric symptoms, aggravated towards morning,

awaking the prover at four o'clock. ° Jaundice, with hyperemia of the liver. {Miller.)

Stomach and Abdomen. Tenderness of the splenic region, with soreness on pressure. Abdomen swollen and tender, with severe splenic pain. Severe abdominal pains near umbilicus; worse on motion. Sharp stitch proceeding from the umbilicus toward the spine,

when taking a deep inspiration, with increased tenderness

on pressure.

A faint feeling in the stomach, with sourish eructations.

A squeezing pain in the epigastrium, worse in bed, with

swollen, but not painful abdomen. Aching of the bowels while walking.

Throbbing, griping pains in the epigastrium, aggravated by a full, deep inspiration, by speaking, and by pressure, causing nausea.

Pain and soreness across the abdomen, and in the epigastrium,

aggravated by standing or sitting erect, and relieved by

stooping forward. Rumbling and swelling in the umbilical region, with slight

vertigo, and sweat on the forehead. Rumbling and bloating in the bowels, with tenderness on

pressure.

Griping, contractive pain in the stomach, moving downwards. Griping, worse on pressure, in the bowels, with rumbling and bloating.

• Pressure as of a stone at the pit of the stomach, aggravated

by light meals. Colicky pains in the small intestines (during the evening) Flying pains in the abdomen, with desire for stool. Stomach feels empty, after eating; sensation of soreness. Severe aching distress in the left hypochondrium. Frequent drawing pains in the epigastric and umbilical region. Stitches in the abdomen, relieved by pressure.

Pain in the epigastrium, with nausea.

Severe pains in the left iliac region, changing to the right; worse on motion.

Severe bearing-down pains in the bowels ; spasmodic and griping, or sharp and throbbing.

Pain in the hypogastrium and bladder, with headache, intermitting during the paroxysms.

Retraction of the abdomen, with pulsations isochronous with the heart.

Soreness of the abdomen, aggravated by motion and relieved

by compressing it with the hands. Abdomen tender on pressure for three weeks after the proving. ° Ascites, probably from hepatic disease. {Miller.)

Stool and Rectum. Sudden and unexpected urging to go to stool, which was

diarrhoeic, with slight tenesmus, accompanied by sweat

on the forehead and head. Urging before stool, with straining during diarrhoeic stool. Constipation, with a continual urging in the rectum. Constant urging to stool, with rumbling in the bowels all day. Small, hard stool, with much straining. Hard and difficult stool, followed by smarting of the rectum. Stools of usual consistence, with slimy coating, accompanied

with straining and vertigo. Involuntary discharge of flatus, with ineffectual urging to

stool.

Urging to stool, with difficult passage of small, hard balls. Constant, ineffectual urging to stool; a continual pressure in the rectum.

Pressure in the rectum all day, resulting in the discharge of a small stool of indurated faeces, with slight relief, apparently a true torpor of the rectum.

Pressure in the rectum, with qualmishness, aggravated by motion.

Violent urging, followed by a stool of fluid consistence and fetid smell ; the passage accompanied with chilliness and straining; and after this, renewed tenesmus.

Urging to stool, and sudden copious discharge of thin diarrlioeic faeces of a cadaverous smell, with smarting of the rectum.

Pressure in the rectum, as in dysentery, not relieved by a stool.

Two stools in succession, of faeces coated with mucus, followed by tenesmus; during stool, shuddering and chilliness of sacral region : after stool, smarting of the rectum, with itching.

Copious stool of fluid consistence and bilious smell; with it was a very copious expulsion of ascarides.

Diarrhceic stools of a dark color and sulphurous smell.

Distress in the small intestines before stool.

Mushy stools; dark-colored, lumpy stools.

0 Chronic intestinal catarrh.

Generative Organs.

Male. — Intense throbbing pain in the glans penis, extending into the pubic region, when retiring.

Increase of sexual desire at night.

Lascivious dreams in the morning.

Female. — Catamenia two days too early, and quite copious. Urinary Organs.

Urine of a deep color, and scalding slightly during passage.

Urine high colored; the yellowish-red of Neubauier and Vogel.

Urine scanty, and of a deep-reddish or reddish-yellow tint, during the whole proving.

Urine less, with a reddish, cloudy sediment.

Urine profuse and of a light color; the quantity decreased and then increased during the proving.

A deposit of muddy sediment in the urine ; afterwards whitish, with increase in quantity.

Pain in the region of the bladder, with headache intermitting.

Uneasiness in the bladder and prostate gland, obliged to rise in the night to urinate.

Tickling and uneasiness in the urethra after urinating.

Smarting and burning sensation in the urethra while urinating.

The quantity of urine increased each day, and afterwards slightly decreased. The condition of the kidneys improved by the proving.

Respiratory Organs.

Aching pain, with occasional stitches in region of diaphragm.

Stitches in the diaphragm, arising from continued speaking.

Stitching pains in the upper part of the posterior medastinum, aggravated hy breathing or a recumbent position, and accompanied with soreness of the trapezius muscles.

• Pressure on the lungs, with a sense of suffocation. Uneasiness and difficulty of breathing, coming on as the

gastric and hepatic symptoms declined; with dull pain, especially in the right infra-clavicular region, accompanied by hacking cough, without expectoration. This has approached very insidiously, and now the right lung is dull on percussion at the apex.

During a full inspiration, sharp pains shoot from the sternum toward the nipples; worse on the left.

Pressure on the intercostal spaces, close to the sternum, causes a dull, aching pain.

These thoracic symptoms are better in the house and aggravated in the keen air.

Cough, with bursting headache, in the morning.

A sharp, darting pain through the upper part of left lung; frequently returning, and aggravated by stepping down.

Pain in the lower part of each lung, in the evening.

Stitches through the right lung, which is sound.

Pain back of the left breast, near the axilla.

Cramp-like pain in the cardiac region.

• Dyspnoea; the walls of the chest feel as though they would

sink in.

0 Asthma (from retrocession of erysipelas). {Hale, Miller?) ° Phthisis; with purulent expectoration of sweetish taste, and hectic fever (probably a bronchial catarrh). (Miller.) Back and Neck. Severe aching in the lumbar and sacral regions, in morning. Pains in the left scapula, aggravated by the exertion of writing. Bruised sensation in all the limbs and back; worse on pressure. Drawing, aching pains in left scapula and shoulder joint. Dull, aching pain in small of the back, aggravated by motion. Severe aching pains in the back, worse in dorsal region.

Hard backache the whole length of spine and back of the neck, also through the right shoulder.

Walking arrested by a cramp-like pain in left sacral region.

Lameness in muscles of the neck, right side.

The whole neck feels swollen.

Dull, heavy pain and soreness in lumbar region.

Upper Extremities.

A tingling prickling in the hands and fingers.

Dry heat over the whole body, especially the palms of the hands and the face, with a feeling as if tl e prover had been up all night; feels worse when the pains are worse. Sleep.

Sleep sound, but haunted by frightful dreams.

Sleep deep and heavy, awaking with racking frontal headache,

aggravated by rolling the eyes upward. The sleep is broken and restless, and disturbed by frightful

and annoying dreams, waking in a profuse perspiration. Sleep restless, and disturbed by dreams and by drooling of

saliva.

Languid on awaking and unrefreshed. Nightmare; of killing snakes; of seeing soldiers; of food. Sleep restless, dream-haunted, with pain in the liver on awaking.

Sleeplessness, almost total, from harrassing pain in the back;

worse in early morning. Languid and drowsy, by day, and bitter taste in mouth. Attacked with a kind of nightmare, on being awakened at

quarter-past nine p.m.; quite conscious, but unable to

stir, on account of a pressing weight on the stomach and

whole front of body.

Fever, Pulse.

Flashes of heat, mingled with chilliness, all day. Pulse 88.

Cold chills running up and down the spine.

Feverish heat, lasting all day, with pains in limbs, and nausea.

Hot, dry feeling on the body, with cold feet.

Dry heat over the whole body, with sweat on the forehead

° Tertian ague, with profuse vomiting of bilious matters.

c Attacks of quotidian ague, continuing for two years, resisting many remedies. (Miller.)

Chilliness and shivering over the whole body, in a warm room; inability to keep warm at the stove (from 500 drops).

Pulse 104; and increase of 32 beats in fifteen minutes.

Shivering in a warm room, with heat of the head.

Shivering over the legs from the hips downwards.

Pulse 126, small and thready, seventy minutes after the large dose; shivering, with chattering of the teeth.

Scarcely comfortable near a large fire; but all the symptoms ameliorated in the open air.

Aching distress in all the joints, with great languor.

Very languid and faint, with flushed face and feverishness.

Pulse increased 12 beats, soft, weak and intermittent.

Pulse slow, strong and irregular.

Hot breath, which seems to burn the nostrils.

Hot flashes, with pain in the top of the head and in the eyes.

Profuse night sweats.

Generalities.

Great lassitude and weariness, with a disposition to hurry through duties.

Extreme weakness of limbs, brain, memory, thought and will;

as if from a powerful and all-pervading disease. Aching of the limbs, especially of the flexor muscles. A fine, violent agitation of all the muscles of the body and

limbs.

Great languor and indifference to duties.

Soreness of the whole body.

Frontal headache during the whole proving.

Rheumatic, drawing, or wandering pains throughout the body.

Flighty, nervous pains, in different parts of the body.

Loss of energy, languor and depression of spirits, (p.)

Unusual aches and pains all over the body, especially in the

abdomen and head. Singing increases the nausea and aggravates the headache,

causing shooting pains from within outwards. Soreness and swelling of lymphatic glands under the right ear. Great restlessness and despondency.

The symptoms assume the form of a severe bilious attack. All the symptoms suddenly disappear after eating sour things All the symptoms are better in the cool, open air. (p.) The thoracic symptoms are worse in the keen air. (s.) The symptoms are all aggravated in the warm room. The gastric and hepatic symptoms are aggravated by pressure

after meals, toward morning and after eating cheese, rich

pudding, butter, or any fatty food; but relieved by motion

in the open air. The nausea is aggravated by lying down or by noise. The pains in the head press from within outwards. The headache is worse after eating or from mental exertion,

moving the eyes, noise, walking, going up stairs, stooping,

or warmth, or during the night, while in bed; but alle

viated in the cool open air, or by pressure. Predominantly aggravated in the warm room, after eating

fatty food, when lying down, or early in the morning,

from noise, or when stooping. Predominantly alleviated in the cool, open air, when rising

from bed, or during continued motion, and by the use of

vegetable acids. From above, downwards, from within, outwards, mainly in the

right side, or from right to left.

Volume II — Special Therapeutics

None of the new indigenous medicines were more thoroughly proven than this ; but for some unaccountable reason it has been but little used, except by the original provers and myself.

If there is any clinical experience on record, it has not come under my observation.

It is a powerful remedy, not violent in its action, like Podophyllum or Iris, but slow, pervading, and possessing the power of causing many chronic abnormal conditions.

It is an analogue of Bryonia, Nux vomica, Arnica, and Hydrastis, and has some affinities with Ruta, Myrica, Sulphuric acid, and Turpentine.

Hr. Tom. Nichol, of Montreal, one of the provers, values it very highly in hepatic difficulties and those erysipelatous and urticarious eruptions so often concomitant with affections of the liver.

It must exert some profoundly injurious effect on the blood, for it causes a condition similar to purpura.

I have found it useful in bilious headache, dyspepsia, gastralgia, congestion of the liver, chronic hepatitis, and chronic erysipelas.

It has been recommended for chronic rheumatism, dysentery, and constipation.

Some English critic intimated that it had been a waste of time to prove Ptelea. He certainly could not have used it in practice, or he would not have made such an absurd assertion.

So highly is this medicine valued in eclectic practice, in indigestion and gastric debility , that a preparation called “ Elixir of Wafer Ash and Pepsin/’ is very popular with that school.

Dr. Farrington has compared Ptelea with Nux, Bryonia, and Arnica, giving us, at a glance, their differences :

Ptelea trifoliata has many symptoms in common with Bry. and Nux vom. All have weak mind, with bodily languor ; peevish, irritable ; senses too easily impressed by external objects, hence, worse from noise, light, smells, conversation, smell of food, etc. Gastric headache ; stomacace ; pharyngitis ; disgust for meat ; hepatic congestion and hepatitis ; ascites (except perhaps Nux) ; dysenteric stool ; constipation, with hard, dry stool ; jaundice ; catamenia too soon ; urine red, highcolored ; red sediment (except Bry.) ; stitches in various parts, worse moving, speaking, breathing ; headache, with cough ; rheumatism, wandering pains ; nettlerash, with gastric disorder ; languor, must lie down ; limbs weak, with nausea, etc.

Ptelea stands between Bry. and Nux v. and Arn., in gastro-bilious diseases. Like Bry., it has hepatitis, better lying on right side ; but the stitch pains do not appear with the least attempt to breathe, only in deep inspiration ; and the stool is dry, hard, small, while Bry. has stool large, dry. Nux v. is worse lying on painful side, and has large stool.

With Arnica, it has eructations like rotten eggs, aversion to meat and longing for acids ; but eating causes epigastric pain and sensation of goneness, not fulness, as in Arn.

Nux vomica has a similar periodic aggravation of gastric symptoms (3-4 a.m.) ; but Ptelea has aversion to fat; Nux a longing. Ptelea, predominating bitter taste; Nux, more sour taste. Ptelea, feels the effect of food at once; Nux, an hour or two after a meal. (Duodenal digestion.)

Ptelea causes dysenteric tenesmus, appearing before and after stool ; in Nux, tenesmus ceases after stool. Ptelea, stool small, hard balls; Nux and Bry., stools too large.

I will add that the oily constituent of Ptelea has many resemblances to Turpentine, and I predict it will prove valuable in typhoid fever (tympanites), and renal diseases (morbus Brightii). It also resembles, in its action on the blood, Phosphorus, Sulph. acid, and Arsenicum.

PICKIO ACID.

Owing to an oversight, the characteristic symptoms of this drug were not incorporated in Vol. I. I therefore give them here. The following symptoms are selected from the provings