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October 2009 | Vol 6 | Issue10

October 2009 | Volume 6 | Issue 10



Article
 
A bird’s eye view of Veratrum album
 

 



Dr. Smita Brahmachari , MD(hom)
Dept. of Repertory
National Institute of Homoeopathy
Kolkata -106
E-mail id :smita.brahmachari@rediffmail.com

    Introduction:

       Dr. Smita Brahmachari is a post Graduate student in Repertory, National Institute of Homoeopathy, under the West Bengal University of Health Sciences. She present her views on Veratrum Album. She had authored scientific articles which had been published in journals. She is an enthusiastic student, presently been selected as UPSC Medical Officer, Govt. of NCT, Delhi.

       Introduction
       Veratrum Album, common names are “White Hellebore” or “European Hellebore” or “Weisse Niesswurz”, belongs to the natural order of the Liliaceæ and is a member of the family of the Melanthaceæ (German = Germer plants). The name “Germer” derives from the old high German word “hram”, a torturing tool, and it was given to this plant family because of the biting, pungent smell of the roots of the white Germer. For the preparation of the homeopathic remedy, the tincture of the root-stocks, collected (in the Alps and Pyrenees) early in June before flowering, is used.

       Hellebore is one of the four classic poisons (the other three being deadly nightshade [Belladonna], poison hemlock [Conium], and aconite). The name Hellebore comes from the Greek word “elein” meaning to injure, and “bora” meaning food.

    Historical perspective
       The use of Hellebore dates back to 1400 B.C., when it was used as a purgative to “cleanse the mind of all perverse habits”. In ancient times the physicians used white hellebore in treatment of chronic diseases because it was capable of exciting excessive vomiting and at last also purgation in physiological large doses. The reason behind such large dose administration was the delusion that existed in the medical art that diseases depended on a morbific matter in the body and cure is possible by elimination of this morbific matter. But there were cases in which patients were cured of their diseases by white hellebore, without undergoing vomiting or purging, failed to convince them that the cures were effected in quite another way. It was mostly used in the treatment of mental diseases especially persons suffering from mania and melancholia by effecting purgation. The use of Hellebore in medical treatment is found in writings through the ages, from the ancient Greeks through the middle ages. It was also used for various animal ailments toward off evil spirits and as a flies repellent. In Europe, it was one of the principal poisons to be used in arrow heads and draggers.

       Hahnemann said in introductory part of the drug, in Materia Medica Pura [Volume III, 2nd edition, 1825], “Physicians have no notion of the power possessed by this drug to promote a cure of almost one third of the insane in lunatic asylums[in such small doses as the twelfth dilutions administered in the patient’s drink], because they know not the peculiar kind of insanity in which to employ it, nor the doses in which it should be administered in order to be efficacious and yet not injurious.”

       On the 26th of June, 1812, Hahnemann presented a Latin thesis, entitled: “A Medical Historical Dissertation on the Helleborism of the Ancients.” (Published in Hahnemann’s “Lesser Writings” ) by which he gained his licence in Leipzic. The thesis was a marvel of research and erudition, where he showed that Verat alb. was the principal agent used at Anticyra and other places in Greece to produce the evacuations which were regarded as an essential of the cure. Spring was deemed the most favourable season and autumn the next. Among the diseases in which treatment was employed were mental derangements, epilepsy, spasms of the facial muscles, hydrophobia, diseases of spleen, goitre, hidden cancer. Hahnemann says in Materia Medica Pura that doubtless many patients were cured but many also succumbed to the enormous doses given. These doses he showed were quite unnecessary when the symptoms of proving are taken as guides.

       The proving of Veratrum is in the 3rd volume of the Reine Arzneimittellehre and is an enlargement of one which had already appeared in the Fragmenta de viribus. It contains 315 symptoms from Hahnemann, 154 from five fellow-observers and 247 from authors. The majority of these are being observed upon melancholic - maniac patients.

    Pathogenesis

       Veratrum album acts profoundly upon the vegetative sphere, blood and nervous system. Its action can be attributed to the presence of 4 crystallizable alkaloids – veratralbine, jervine, pseudo-jervine and rubijervine. It causes disorganisation of blood and separates into constituent components. As a result there is general topor of the vegetative system. It give rise to choleric condition, general coldness, prostration, collapse, copious watery vomiting, purging, spasmodic colic, cramps and spasms. Its action on the nervous system results in excitation of the cerebral nerves producing delirium and mania, in addition to great exhaustion of nerve power.

    Clinical
       Angina, apoplexy, asthma, cholera, colic, collapse, constipation, cramps, diarrhoea, gastric and abdominal disorders, headache, influenza, mental diseases, menstrual disorders.

    Keynotes guiding its use in various clinical conditions
    1. Profuseness of all the discharges which runs through the whole remedy- in diarrhoea, vomiting, sweat, urine, salivation. The discharges drain the tissues and exhaust the vitality.

    2. As a result there is vertigo, blackness before the sight, fainting, collapse, rapid sinking of the vital force and complete prostration.

    3. There is coldness running over the whole body, but the most characteristic of all is “cold sweat on forehead” with nearly all complaints. Along with coldness there is blueness of face and extremities.

    4. Craving for acids, juicy and refreshing things, fruits, cold food and water. Intense unquenchable thirst for large quantities of cold water; wants everything cold.

    5. Margret Tyler summarises. - “The cry for Veratrum then consists of excessive coldness, excessive cold sweat, extreme thirst, extreme violence of evacuations, extreme copiousness of vomiting, purging and sweat, collapse, paralytic weakness and loss of power, with violence of reactions to pain and mania”.

    6. Mind - Kent says mental symptoms are marked by violence and destructiveness. Mental pictures is revealed in usually the arrogant way in which Veratrum insist upon his own way and the dogmatism with which he expresses his opinion. P.Bailey says he is a Little Hitler, very bossy people without sign of regret.


    7. Rubrics in Kent’s Repertory depicting the mental state
    The Materia Medicas are full of references to Veratrum’s potential for violence (Kent: ‘Abusive’,    ‘Biting’, ‘Delirium-raging’, ‘Delirium-pains, with the’).

    The social etiquette that we take for granted is often poorly mastered by Veratrum, who is liable to    laugh a little too loud, or to launch into a description of his symptoms immediately upon sitting    down, without waiting for the homeopath to address him (Kent: ‘Rudeness’).

    His arrogance is expressed by his, always arguing attitude (Kent: ‘Haughty’). (Kent: ‘Quarrelsome’).    But he is offended easily (Kent: ‘Offended easily’).

    Veratrum people are often prone to manic-depressive psychosis, but the manic phase (Kent:    ‘Mania’) is generally more prominent than the depression. The patient shows all the typical features    of mania when describing his behaviour during a manic episode. At times he was extremely restless    (Kent: ‘Propensity to be aimlessly busy’), spent too much money, propositioned strangers sexually    (Kent: ‘mania-erotic’), and would not eat for days (Kent: ‘Refuses to eat’). Veratrum is very restless    type at the best of times (Kent: ‘Restlessness-anxious’).

    Following manic phases Veratrum may enter into a depressive phase, which is characterised by    brooding (Kent: ‘Brooding, evening’) despair (Kent: ‘Despair, religious, suppressed menses, during,    social position of’). The depressed Veratrum will sit silently for hours thinking about how wretched    he feels, and imagining that he will never feel any better (Kent: ‘Despair of his recovery’).

    One very characteristic feature of the Veratrum personality is a tendency towards religious    fanaticism. Usually such religious fanaticism involves the threat of damnation and the possibility of    redemption. Veratrum may be obsessed with the thought that he is damned (Kent: ‘Anxiety about    salvation’), and try hard to be pious and make amends for his sins, (Kent: ‘Praying’), or he may    adopt an evangelist’s role and try to convince others that they must repent and turn to the Lord    (Kent: ‘Exhorts to repent, preaches’), (Kent: ‘Exalted state of religious frenzy’).

    Veratrum is highly active like Stramonium and Tarentula more so than Hyos. (Kent : ‘Industrious’)    but it is not so violent or threatening as Stramo. or Tarentula. It becomes violent in extreme states.    The person believes himself to be superior than those around him (Kent : ‘Haughty’). He may    become overly critical, censorious (Kent : Censorious, critical, disposed to find fault or is silent). As    this tendency grows the person becomes less in touch with discrepancy between his reality and    others, he may believe himself to be the only one who is sane, all others being insane. Finally this    develops the full religious righteousness.

       Other indications in comparison with leading remedies
    Cold sweat on forehead [Carbo veg, Opium, over the entire body - Tabacum]

    Lascivious talk, amorous or religious [Hyos., Stramo]

    Fainting from least exertion [Carbo veg, Sulph]

    Sinking during haemorrhages [Trillium with fainting]

    Sensation of lumps of ice on vertex with chilliness [Sepia]

    Facies hippocratica [Acon., Carb-v, Chin, Sec., Tab]

    Craves acids or refreshing things [Phos ac.]

    Cold feeling in abdomen - external [Ambra-one side only, Colch Meny-chill during, Tab.- whole    body]

    Vomiting < by drinking [Ars.], < least motion [Tab.]

    Large hard stools [Bryo., Sulph.]. Round black balls [Chel., Op., Plb.]

    Frequent desire for stool felt in epigastrium [Ign., Nux.-in rectum]

    Weakness at menses [Alum., Carbo an., Cocc.]

    Collapse, cholera, coldness, < by heat [Camph. has scanty, Ver.- copious stools]

    Rheumatism < in wet weather, which drives patient out of bed [Chamo.]

    Delirium [Bell., Stramo.,- these have not the cold surface and cold sweat of Veratrum], Loquacity    [Cup., Hyos., Lach., Op., Stramo.], Gossiping, babbling [Hyos., Ver. on religious subjects], kisses    everybody [Agar]

    Fright diarrhoea [Acon., Arg nit., Gels., Opium, Veratrum – coldness of body and prostration]

    Cholera [Jatropha c.-vomits ropy, albuminous matter with purging, Podo.-painless, Iris ver.- better    for summer complaints, excoriated raw feeling at anus, Crot tig – single gush, every attempt to eat    and drink causes stool, Elat.- olive green stools, Ver.- colicky pain through abdomen with cramps in    calves of the legs., Camph.- with scanty discharges and nausea, Cup met.- cramps]

    Suppressed scarlatina [Zincum, Ver. has succeeded when Zn. has failed to produce reaction]

    Emaciation about neck [Nat mur, Veratrum especially in whooping cough]

    Weak from talking [Stann., Cocc., Sulph., Calc.]

    Collapse, diarrhoea, vomiting [Ant.t.-more drowsiness, Ver.-more cold sweat]

    Neck muscles too weak to hold head up [Ant.t]

    Craves cold drinks [Ars., Veratrum is between Ars. and Nux.]

    Purging and collapse [Helleborus - apathetic]

    Pressure in vertex with pain in stomach > pressure < motion [Puls].

    Abdominal pain [Coloc., Ver. must walk about]

    Pain associated with fainting [Chamo., Hepar., Valer.]

    Convulsions after sudden emotions [Ign.], Convulsions with spasm of glottis [Nux., Ver. secondary    to exhausting diseases]

    Causation
       Fright, shock of injury, disappointed love, injured pride or honour, suppressed exanthemata, bad    effects of opium eating and tobacco chewing.

    Relations
    1. Antidoted by : (Poisonous doses) few cups of strong coffee, Camph. (pressive pain in head with    coldness of body and unconsciousness after - Hahnemann), Acon. (anxious, distracted state with    coldness of body or burning in brain - Hahnemann); China (other chronic affections from abuse of    Ver. – e.g., daily forenoon fever - Hahnemann), staphy.

    2. Antidote to : Cuprum (colic), removes bad effects of opium and tobacco chewing.

    3. Follows well : Camph. (cholera), Amm.c., Carb.v., Bov. (in dysmenorrhoea with vomiting and    purging), Lyco and Nux in painful constipation of infants..