Xanthoxylum fraxineum

Volume I — Special Symptomatology

(Prickly Ash.)

Botanical Descriptor— A shrub, ten or twelve feet in height, with alternate brandies, which are armed with strong, conical, brown prickles, with a broad base, scattered irregularly, though most frequently in pairs at the insertion of the young branches. The leaves are alternate and

pinnate, the leaflets about five pairs, with an odd one, nearly sessile, ovate, acute, with slight vesicular serratures, somewhat downy underneath. The common petiole is round, usually prickly on the back, and sometimes unarmed. The flowers are in small, dense, sessile umbels, near the origin of the young branches ; they are small, greenish, dioecious, or polygamous, appear before the leaves, and have a somewhat aromatic odor.

[The X. Caroliniamim is the only other indigenous species. It is found only in the Southern States, and is a large tree, sometimes growing forty feet high, and having a diameter of ten or twelve inches.]

Officinal Preparations. — Tincture of the berries and bark ; dilutions.

Analogues. — Camphora, Ammonium carbonicum, Asarum, Veratrum album.

Mental Sphere.

Great despondency; irritability. Anguish about the chest.

Fearfulness; terrible nervous frightened feeling.

Head.

Head feels full and heavy.

Vertigo; bewildered feeling; insensibility.

Pain over both eyes, throbbing pressure above root of nose.

Grinding pain in the head, with nausea.

Severe pain in top of head, as if it would come off.

The head feels as if it was divided.

Eyes.

Lachrymation; pain in the lid of right eye. Dull heavy pain in the left eye. ° Ophthalmia. {Dr. Cullis.)

Ears.

Dull pain in the left ear; ringing in the right ear.

Nose.

Fluent coryza.

Discharge of bloody scales of mucus from the nose, right side.

Face.

Pain in the right jaw-socket.

Dull pain in the left side of the lower jaw.

Mouth.

Ptyalism; tongue coated yellow.

Throat.

Throbbing in the throat, and sensation of swelling. Soreness, with expectoration of tough mucus.

A. " bunch " in left side of throat when swallowing. Aphonia, from cold or general debility.

Stomach.

Fluttering in the stomach; feeling of fullness.

Abdomen and Stool. Fullness and pressure at the epigastrium, with colic pain in

right iliac region. Rumbling, with soreness on pressure.

0 Epidemic dysentery, characterized by spasmodic tenesmus,

intestinal spasms, tympanitis, etc. Inodorous discharges, with tenesmus.

c Cholera, in the stage of collapse (when Veratrum album fails).

Urinary Organs. Profuse and light colored urine.

Generative Organs. Women. — Menses too soon. Profuse menses, with violent pains. ° Leucorrhoea, with amenorrhoea. ° After pains 0 Menorrhagia, and threatened abortion. ° Amenorrhoea, recent. {Dr. Cullis.)

0 Amenorrhoea of one year's standing. A girl set. 18: paleness of face, lips, tongue, fauces and conjunctiva; face bloated, with dark rings round the eyes; appetite poor; abdomen bloated; urine cloudy, and deposits a brick-dust sediment, scanty; oedema of feet and limbs, great weakness, dyspnoea and a chlorotic condition. (The first dilution brought on the menses in four days, after other remedies had failed; cure completed by Calcarea and Ferrum. {Dr. C. A. Williams.)

0 Amenorrhea for jive months; face and legs oedematous; very nervous, sensitive to the least noise', hysterical mood; voice tremulous; fears she is going to die; general chlorotic appearance, constipation, scanty, frequent and dark urine; (the 1st dil. cured this case in a few weeks.) {Ib.)

0 Amenorrhoea for five months; with severe pains over right ovary; constant headache; bearing down and tension in hypogastric region, (the 1st, soon relieved the pain in the head, and restored the menses in a few days.) {H>.)

° Amenorrhea from getting the feet wet; lasting six months. Symptoms: emaciation, with cough; dirty -gray expectoration; pale face, night sweats, (cured in a short time by the 1st.) (Ib.)

° Ovarian and sacral pains during pregnancy . (Ib.)

° Ovarian pains, with scanty and retarded menses. (Ib.)

° Dysmenorrhea, with agonizing pains, driving patients almost distracted. (Dr. Cullis.)

° Is indicated in neuralgic dysmenorrhea by the presence of pain along the course of genito-crural nerve. Spare habit, nervous temperament, and delicate organization, seems more particularly to call for this remedy. (Dr. Massey, of England. " Botes on New Remedies") Chest.

Oppression of the chest, with a desire to take deep inspiration. Shortness of breath.

Tightness of the chest; difficulty to inflate the chest. Pain in the left side, under the fourth rib.

Arms.

Pain in the right shoulder and arm.

Pain and pricking feeling in the right arm, extending to the

third finger. Numbness of the left arm.

Pricking and throbbing sensation in the left arm and fingers.

Legs.

Excessive weakness of the lower limbs. Pain in the left leg, between hip and knee.

Generalities.

Prickling sensations extending to the whole body and extremi. ties.

Gentle shocks, like electricity, pouring through the body.

Numbness all through left side of the body.

0 Paralysis of single members.

° Hemiplegia, after Nux vomica failed.

Fever, with flushed and hot face, followed by great depression

Flashes of heat from head to foot.

Nausea, followed by chills.

° Typhoid fever, in the stage of collapse.

Volume II — Special Therapeutics

This medicine is prepared — or should be — from equal parts of the berries and bark of the Prickly ash.

It has been alternately praised and depreciated by physicians of all schools. It is a powerful remedy and will some time find its true place in homoeopathic therapeutics. I gave the following history of it in the second edition of “ New Remedies

Eafinesque seems to have been the first physician who investigated its qualities. He says : “ This is a great article in the materia medica of our Indians ; it is called Hantola by our Western tribes ; they prefer the bark of the root and use it in decoction for colics, gonorrhoea, syphilis, rheumatism, inward pains, toothache, ulcers, etc. It is a great topical stimulant, changing the nature of malignant ulcers.”

Eafinesque seems to have had a correct idea of its general powers. He says : “ The Xanthoxylin, which was discovered by Dr. Staples, is crystallizable and resembles Piperin. This article appears to be equivalent to Mezereum and Guaiacum in properties. The acrimony is not felt at first but unfolds itself gradually by a burning sensation on the tongue and palate.” He estimates it very highly in chronic rheumatism.

King does not add much to the above except to narrate its usefulness in cholera. He decrees the bark to be “ stimulant, tonic, alterative, and sialagogue.” The berries, he says, are “ stimulant, carminative, and antispasmodic, acting especially on mucous tissues.”

Paine says of the Xanthoxylin : “ It is one of the most active diffusible stimulants known to the profession, when administered in doses of from one to two grains. In the healthy person it produces a warm glow through the entire system, and a slight tickling (tingling?) sensation of the nerves, as though gentle shocks of electricity were passing through the body.”

From all that I can learn of the effects of the bark and berries, in health and disease, I am inclined to consider the analogues named in Vol. I have a close similarity in action to the former ; while Camphor seems very closely analogous to the latter portion of the plant. The Xanthoxylum was first introduced into homoeopathic practice by Dr. Charles Cullis, of Boston, who brought it to the notice of our school in a Eeport of the Committee on Materia Medica of the Massachusetts Medical Society, and contributed to the first edition of this work. He presented six provings, three of which were made on women.

Its action on the general system is similar to Ammonia. The following symptoms show that it acts on the nervous system : Prickling sensation in the nerves ; gentle shocks, like electricity, pouring through the whole body ; a feeling of numbness through the whole left side of the body from head to foot. It appears to irritate and stimulate the nerves of sensation, as witness the prickling and tingling sensation, felt not only in the mouth, but all through the body, after its administration. On the nerves of motion it probably acts in the same manner, namely, irritating and exciting by its primary action, and benumbing or rendering torpid by its secondary effects.

While it would be indicated by its primary action in neuralgia, and other painful affections of the nerves of sensation, and in spasms and abnormal action of the nerves of motion, it would be secondarily indicated in paralysis or torpor of both.

Dr. Paine records that he has used it very successfully in many cases of paralysis. He also cured one case of hemiplegia by the use of small doses of Strychnine and Xanthoxylin, in the proportion of one grain of the latter to one-sixteenth of a grain of the former, four times a day. The patient had previously taken Strychnine without any effect, but by adding this remedy it soon manifested its power.

It primarily stimulates the muscular system through its exciting action on the nerves.

On the mucous membranes it acts directly by its topical effects, and also through the nervous system. The berries seem to have a peculiar affinity for this membrane.

It excites the glandular system by its irritant action in the same manner as its analogues above mentioned. It may be found useful when the glands of excretion are irritated and pour out undue quantities of their peculiar secretions; or, when glands become torpid and fail to do their duty. To both these opposite states this medicine is homoeopathic.

I am of the opinion that this medicine will be found useful in the lowest attenuations in torpid conditions of the nervous system, with a sluggish circulation. It will act well in alternation with the hypophosphites in such conditions.

It has been used in sudden faintings and collapse in large doses, but I think we have better remedies. Its action on the heart has not been investigated.

No allopathic or eclectic authority, except Professor Paine, mentions the use of this medicine in fevers. Paine says he has used the Xanthoxylin in the low stage of typhus and typhoid fevers, especially when there was periodicity. He says it stimulates the torpid functions to activity, and enables absorption and assimilation to be carried on. He does not, evidently, suppose the drug has any direct curative action.

This may or may not be the case. I am inclined to the opinion, however, that had we a full pathogenesis, we should find this drug homoeopathic to some forms of nervous and typhoid fevers, and perhaps in the latter stages of some of the febrile exanthemata.

“ In exanthematous fevers,” says Paine, “ especially diphtheria and malignant scarlatina, I have used the Xanthoxylin, combined with Macrotin, to produce a reaction, and transfer the disease to the cutaneous surface, with most happy effect.”

Had the combination not been made, this observation would have been of considerable value. However, from what we know of Xanthoxylum, we may believe it to exert the same beneficial influence in these diseases as does sometimes the Ammonium carbonicum, of which it is a close analogue.

In typhoid fever the tincture of the berries would be indicated in about the same conditions as Ammonium carb. or Terebinthina. It is recommended by King in “ tympanitic distension of the bowels during peritoneal inflammation, used internally and as an injection.” Turpentine is indicated, and is a specific remedy in the same condition, but the pathological state curable by Xanthoxylum is not as formidable as that amenable to Turpentine. The former will probably cure the intestinal ulceration which attends the tympanites of typhus, although it might alleviate the distension by restoring the contractility of the paralyzed muscular coats of the intestines.

One of the most important of all the effects of Xanthoxylum is, doubtless, its action on the mucous and muscular tissues of the intestines.

The tincture of the berries appears to be the most useful preparation in the treatment of intestinal disorders. Eclectic authorities are unanimous in asserting its usefulness in spasms of the bowels , flatulency, diarrhoea, and tympanitic distension during enteritis.

The few symptoms recorded seem to point towards such an action. If heroic provings were instituted, it would doubtless be

found that this drug would cause those abnormal conditions which it is said to cure.

The most important clinical fact relative to the use of this medicine is its efficacy in cholera. Sufficient testimony is recorded to warrant us in admitting its usefulness in that terrible disease.

In Asiatic cholera , says King, it was extensively used by many of the physicians in Cincinnati, and with great success ; it acted like electricity, so sudden was its influence over the system ; indeed, many patients likened it to an electric shock, which seemed to diffuse itself through the whole frame. We gave it (the tincture of the berries) in teaspoonful doses, slightly diluted, and repeated according to circumstances, every five, ten, or fifteen minutes, with an injection (of onehalf fluid ounce tincture ; Laudanum twenty drops), which was given immediately after each discharge from the bowels, and retained by the patient as long as possible.

This would be good testimony in favor of the real efficacy of the Xanthoxylum, if it had not been absurdly combined, in the injection, with Laudanum. The eclectics cannot rid themselves of the allopathic notion of combination. In the allopathic treatment of cholera, Laudanum is always mixed with Camphor, although the two are antidotes, and notwithstanding the fact, so notorious now, that the use of Opium in any form increases the mortality of cholera patients.

Perhaps, in consideration of this fact, we ought to credit the Xanthoxylum with powerful curative effects, inasmuch as it acted favorably, notwithstanding its union with a drug so useless and injurious as Laudanum. It is my conviction that the Xanthoxylum acts in cholera in a manner quite similar to Camphor and Veratrum album. It seems to possess some of the properties of both, and many of its symptoms resemble those of each drug, as witness the “ tingling and electric-like shocks, which resemble those of Veratrum album, and the peculiar nervous stimulation resembling that of Camphor.

Dr. Morrow (eclectic) used the medicine alone, with very good success, in cholerine cases in Cincinnati, in 1849.

In the treatment of dysentery, it is valued very highly by eclectics, who use it internally and by enema, after the acute inflammatory stage has subsided ; also for the tympanites which sometimes occurs. Dr. P. H. Hale made use of it in a severe epidemic of dysentery which devastated Michigan in 1866. After Aconite

and Mercurius corrosivus had controlled the first stage, there occurred a condition which no remedy seemed to relieve. The symptoms were intense spasmodic tenesmus , intestinal spasms , tympanites, failure of strength, nervous prostration, jactitation, numbness, and sometimes symptoms indicating collapse of the vital forces. For these symptoms the Xanthoxylum was prescribed. The tincture of the berries was given in two, three, or five drop doses, every hour or two, sometimes oftener, and a weak infusion of the berries (one drachm to one quart of water), used as an enema, a few fluid ounces thrown up the rectum after each discharge from the bowels. This treatment was very successful, and succeeded in relieving cases which could not be relieved by any other.

Xanthoxylum appears to have an affinity for the sexual organs of women.

Dr. Cullis, of Boston, reported the two following provings made by women :

(1.) Mrs. IT., aged thirty. Took ten drops of the tincture at 9.20 P.M. ; pulse 80. Soon after taking it, began to experience a feeling of depression and weakness ; weakness of the lower limbs, with pain in the knees. At 8.30 p.m., pulse 74, soft ; slight nausea, with sense of oppression at the stomach ; nausea increased, as did the pains of the extremities, accompanied with frequent chills. Next evening the same prover took twenty drops of the tincture ; did not experience the feeling of depression in so great degree as the night before ; the weakness of the limbs and pain in the knees about the same ; some pain in the left side ; menses appeared next morning, being one week before the usual time ; was attended with a good deal of pain.

(2.) Mrs. J., aged twenty-eight, light complexion, sanguine temperament, good health. Took twenty drops of the tincture at 8 o’clock p.m. In about twenty minutes noticed a tightening of the scalp, and heavy pains in the temples, with a twitching in the left knee and trembling in the right. On the following day, took at 11 o’clock A.M., twenty drops; felt the same feelings in the head ; did not notice the lower limbs. 2 o’clock p.m., took twenty-two drops ; felt the same headache, or severe pain and tightening. 3 o’clock p.m., took twenty-five drops ; increase of head difficulties, with a great heat and a quiet flowing (menstrual), being two days in advance of proper time. 8 o’clock p.m., took twenty drops ; some headache ; all the system quiet, with an unnatural forcing of nature ; went to sleep as usual, and awoke in dreadful distress and pain, baffling description ; profuse flowing ; the pain, or agony, continued until noon of the next day, when it gradually subsided.

These provings prompted him to prescribe the Xanthoxylum

in cases of dysmenorrhoea, and he afterwards published the results. He says :

Clinically, I have used this remedy in dysmenorrhoea and amenorrhoea with marked success. One or two cases will serve for an illustration.

Miss A., aged twenty-five, brunette, has suffered from menstrual irregularities since their first appearance ; the catamenia appearing in three, four, or five months, and at that time her sufferings were excruciating. Her general health otherwise was good. At the time of consulting me she had not had her catamenia for two months. I gave her Xanthoxylum, 1st dilution, five drops three times a day. In three days her menses appeared, and, much to her joy, with little pain.

Miss B., light-complexioned, nervous temperament, aged twenty-five, consulted me for suppression of the menses, caused by getting the feet wet, she being then about one week past her time. I gave her Xanthoxylum, 1st decimal, five drops every three hours. Her menses appeared the next day.

Mrs. C., aged thirty-two, mother of ten children, a large, fleshy woman, had not menstruated for five months, and previous to that time had not for three or four months. Gave Xanthoxylum 1st, to be taken three times a day. Menses appeared in four days.

In dysmenorrhoea, I have used this drug with very satisfactory results. I will quote one marked case :

Mrs. D., aged twenty-six, spare habit, scrofulous diathesis, had suffered for years from dysmenorrhoea. Her sufferings were so great that she would be confined to her bed for two or three days. She had tried all sorts of treatment, but without any relief. She came under my care, saying the only way she could live through her menstrual period was to drink whiskey or gin until she was intoxicated. For several months I treated her with the usual remedies, but without any beneficial result. I then gave her Xanthoxylum, 3d decimal ; this completely cured her. She was extravagant in her praises of this remedy. It has never failed to relieve her.

I think Xanthoxylum more especially indicated in females of spare habit, nervous temperament, and delicate organization. In some cases of plethoric habit it has never failed me. In leucorrhoea with amenorrhoea, it has proved very successful. In after-pains in obstetric practice, I have found it of inestimable value ; also in profuse flowing and threatened abortion.

Within a few years, and since the above was written, several physicians, especially Dr. Williams, of Joliet, claim to have used it with almost marvellous effect in dysmenorrhoea ; others, physicians of close observation, have carefully followed the dose and repetition recommended by Williams, and failed to cure.

This failure in the hands of some, and success in others, cannot be accounted for, except on the theory that it was not affiliated properly. It appears to me that Xanthoxylum is only indicated

in dysmenorrhoea where the neuralgic element predominates. It is well known that what one physician considers congestive another would consider neuralgic.

Again, it is well known that a remedy which will relieve a neuralgia at one time will fail at-another. Unless a medicine corresponds to the primary cause of a neuralgia, it is only a palliative.

I have often relieved a neuralgic dysmenorrhoea completely with Xanthoxylum, Viburnum, or Iodoform, and there would be perfect immunity from pain, for three periods, under the use of the remedy. But, very strangely, at the fourth period the old sufferings would come back ! I would have to select some other remedy and would meet with the same results. I have known similar alleviations to occur from change of climate. Some women always have dysmenorrhoea while they remain in Chicago, but are free from suffering when in New York or Boston. Others I have known whose experience is just the reverse.

In Volume I will be found a brief narration of several cases of amenorrhoea of long standing, cured by the use of the lx. They were all chlorotic, and suffered with ovarian pains. I have cured several presenting similar symptoms. Other physicians report adversely of its curative power in such cases. (I prefer the tincture of the berries.)

Dr. Massey, of England, has perhaps hit upon a keynote for its use. lie says it is indicated in dysmenorrhoea, when severe pains follow the course of the crural nerve.

I would advise it in sciatica and crural neuralgia, and also rheumatalgia, when occurring in patients having a sluggish circulation.