Piper methysticum

Natural History.
      Macro piper methysticum.
      AV. Kava-kava. Kawa. N. O. Piperaceae. Tincture of fresh root.

Clinical.
      Albuminuria.
      Anus, prolapse of.
      Brachialgia.
      Brain-fag.
      Catalepsy.
      Cystitis.
      Dysuria.
      Eczema.
      Gonorrhea.
      Headache.
      Head, enlarged feeling.
      Ichthyosis.
      Leprosy.
      Neuralgia.
      Neurasthenia.
      Orchits.
      Paraplegia.
      Prostatorrhœa.
      Rheumatism.
      Toothache.
      Urethritis.
      Uric acid, excess of.

Characteristics.
      Piper methysticum (it is called Macro piper methysticum in most recent botanical words, but I retain the order name by which it is best known in homeopathy) furnishes the root called Kava in Polynesia. The natives use it as a stimulant, either chewing the root or drinking a beverage made of it before undertaking any important business or religious rites.
      Excessive indulgence in it produces a skin disease like leprosy, called at Tahiti Arevareva. Lutz (quoted H.W., xxviii. 175) describes the disease as observed amongst natives of the Sandwich Islands:"The skin, par marked ichthyosis, associated with a certain degree of atrophy, such as is observed in senile skin.
      There is an absence of inflammatory symptoms." The mental symptoms of the "Intoxicating Pepper" (, drunkenness) are the most interesting feature of the drug’s action.
      W. N. Griswold proved the third and second dilutions, and developed a large number of nervous, mental, and brain symptoms, among which are some which have proved to be keynotes.
      The drug causes a feeling of buoyancy, as if every nerve was strung up to the highest pitch, feels he can work without fatigue, quickly followed by a feeling of tired brain, and over-sensitiveness to all external impression.
      Mental tension, feeling as though the head were enlarged even to bursting.
      The mental symptoms, excitement or depression, and the headache, were better by diversion of mind.
      This is one of the keynotes, and it has served to indicate Piper m. in connection with other symptoms.
      Griswold cured a case having burning in chest, better by diverting mind (Org., i. 229), and three cases having: "Agonizing pain, with tossing, twisting, and writhing, patient driven irresistibly to change position, which generally gives little or no better." This italicized passage is the second keynote of Piperm. These cures were with the 1 x or tinctures.
      Skinner gave fractional doses of tincture in water to a highly excitable young girl who had severe toothache and earache, and had worn out her family by the incessant day and night attendance she required.
      The pains were dragging, heavy, worse at night in bed, and after or when eating, "forgets all about her pains if amused with anything, but directly she is tired of it she exclaims ‘Oh, my tooth or ear!" In addition she had "Agonizing pain with tossing, twisting, and writhing, irresistibly driven to change position." The patient slept well that night the first time for a fortnight, and had no more pain.
      The remaining swelling was removed by Puls. 200.
      Skinner also reports this case: Miss R., 20, has toothache in a decayed molar, better if attention is diverted by anything is diverted by anything sufficiently exciting.
      When pain is at all violent she has no rest in any position, must keep continually changing it.
      Piper m. 500 (F. C.) was given, and there was relief very soon after the first dose.
      A few doses completely removed the pain (Org., i. 299).
      Piper m. has much dizziness and vertigo, better on closing eyes.
      The forehead was full, "solid with pain," this shifted to occiput and cervical spine, where it became a compression, extending as a constricting sensation to stomach and chest.
      The sensation of enlargement of head was marked and persistent.
      Farrington says convulsions simulating catalepsy are produced Cerna (quoted H. W., xxvi. 556) as a result of his investigations found Piper m. a general and local anaesthetic.
      It diminishes reflex action by its action on the cord, and kills by paralysing respiration.
      Cerna illustrated its relationship to Cubeba by citing cases of gonorrhea, acute and chronic cystitis, gleet, prostatorrhea, vaginitis, cured with it.
      The provings give the indications.
      The symptoms were worse before meals (sour eructations), reading and thinking, urinating (burning in urethra), walking.
      Going down stairs causes symptoms to rush up.
      Better moving, diverting mind, open air, closing eyes (vertigo).

Relations.
      Antidoted by: Puls. and Rhus (partially).
      Compare: Cubeba, Piper nig., Matico (botan.).
      Is better by diverting mind, Ox. ac. Better by motion, Rhus. Feeling of buoyancy, Coff. (but with Coff. the reverse condition of brain-fag does not quickly follow).
      Neurasthenia, Pic-ac., Arg-n., Avena. Unbearable pains, Coff., Aco., Cham.

Mind.
      Hilarious from ten AM till one PM
      Lively after an emission.
      Lively and inclined to work, can dance with more ease than usual.
      Agreeable excitement and support against great fatigue.
      From increased doses intoxication of a sorrowful, silent, and sleepy character, different from that produced by alcohol.
      Faculties sharpened.
      (capable of working more without fatigue or brain-fag.)
      Lazy and drowsy.
      Deep torpor and irritation from least noise (intoxication from root grown in damp soils).
      Want of vigor, timid, apprehensive.

Head.
      From 5 to nine PM very dizzy, swimming sensation and faintness.
      Intoxication, with fantastic ideas and desire to skip about, although he cannot for a moment hold himself on his legs.
      Vertigo in morning in bed, with frontal pressure.
      Brain tired, in morning on waking, better getting on feet.
      Tired feeling in brain at night.
      Fullness, sometimes in one part, sometimes in another, worse in forehead.
      Heaviness of head.
      Headache with pressure in upper part of orbits, with sleepiness.
      Shooting: intermittent after three PM, in left supraorbital nerve, in left temple.
      Headache: in left supraorbital nerve, back of eyes, left brain from front to back, over eyes and deep-seated, at nine AM, worse three PM, in afternoon and evening with drowsy and stupid feeling, above eyes at five PM, at seven PM, in left side and deep in upper part of orbits, with pain on moving eyes, intermittent in right frontal eminence, better open air and motion, above right eye radiating over eyes, at ten AM, heavy in forehead and temples, worse thinking and reading.
      Frontal brain "solid with pain," this ache during day generally moved to base of brain and along medulla., better by slight motion, worse by large, continued and active motion, slight mental effort, passing from topic to topic, for an instant better, sustained effortworse.
      Compressive pain and soreness back of head and cervical cord, disappear later leaving cerebellum sensitive, parts feel treble their normal size.
      Dullness in forehead, with fullness and pressure, and on raising head or moving it to either side vertigo, after the noon meal the pressure shifted to lateral and occipital regions, worse lying down, but not amounting to real pain, pressure, worse remaining in one position, better moving, apprehension of pain by rapid movement, but temporary relief from it.

Eyes.
      Conjunctivae red.
      Pain along right optic nerve when reading at three PM
      Pain deep in left eye as if ball would be pressed out, in the street at 5.30 PM
      Dizzy blindness when dressing, vertigo, better closing eyes, directing attention to head and exerting the will, at the same time vertigo, then rush of blood and fullness in forehead, then similar sensation in occipital and basilar regions.

Ears.
      Singular pressure in lobules of pinna of left ear.

Face.
      Pressure outward in face at seven PM

Teeth.
      Teeth deep yellow.
      Teeth sensitive to cold water, cold air, brushing, *c.

Mouth.
      Tongue feels as if covered with velvet or fur at night.
      Burning on tongue.
      Burning in whole mouth followed by numbness.
      Dryness of mouth on waking from afternoon nap, with sweat (in a hot day).
      Salivation.
      Taste: nauseous, sweet, then piguant and sharp, pappy, everything tasteless, lost to food, but ravenous haste in eating.
      Taste and relish to food not as usual, at noon, but appetite usually good.

Appetite.
      Appetite: formidable at eight PM, slight, hungry at noon, but not able to eat much, able to eat but little supper.

Stomach.
      Sour eructations, worse an hour before meals and at night, at times rolling up and rumbling from stomach to mouth, but generally breaking at throat-pit, and in throat-pit sensation of something that cannot be swallowed, the latter temporarily better by eructations.
      Bloating at eleven PM
      Constriction extending from base of brain.
      Crampy pain, better pressure against edge of table.
      Warmth in stomach.

Abdomen.
      Pain: every day about nine AM, in forenoon after first stool, with difficult in evening, soft, difficult.
      Constipation: stool hard, large, light-colored.
      Stool large, soft.
      Urging: all day, every evening.
      Continuous desire, next day forced a large stool, which caused prolapsus ani.
      Burning in rectum.

Urinary Organs.
      Micturition at 4.45 AM
      Burning in urethra during micturition.
      Urine nearly neutral at ten AM, hot and over-acid at night.
      Urine: increased, scanty in morning.

Male Sexual Organs.
      Shooting in penis.
      Erection: in afternoon, at night, at four AM after an emission.
      Pain in right testicle.
      Emission early in morning, without dreams.
      Amorousness.

Chest.
      Heaviness behind upper part of sternum, as from wind that cannot be eructated.
      Constriction of chest and stomach, extending from base of brain.

Heart and Pulse.
      Pulse steadied.

Back.
      Pain in back only felt on pressure.
      Soreness about second dorsal vertebra.

Limbs.
      Pain: in right foot and wrist and left toe at ten PM, right elbow and left knee, with stiffness, right foot and back of left hand at 11.30 PM, with heat of them.
      Pain in right arm as if marrow would be affected, changing its location, with paroxysmal paralysed feeling in hands, in toe a nine PM

Upper Limbs.
      Pain: in left shoulder, in left arm in the street, with flushing heat in left hand.
      Excoriating pain in right arm, as if the marrow would be affected, paralysed feeling in hands.
      Pain in right arm, running in all directions, with heaviness, soreness, and tired sensation.
      Dragging in left arm at eight PM, worse ten PM
      Tingling as from an electric current from left elbow to fingers.
      Numbness of right elbow.
      Pain in right wrist, worse writing.
      Weakness of left hand.
      Pain in joint of left thumb, worse pressure.

Lower Limbs.
      Drunk in his walk, but intellect included, aware of his inability to control the movements of his legs.
      Numbness of lower limbs.
      Weakness, all day, in afternoon, in things as if unable to stand.
      Sticking in left knee at four PM when walking.
      Heaviness of legs when walking.
      Pain: in feet, left foot and toe, right sole, at outer and under border of left foot and in right great toe, with coldness of left foot.
      Sticking: in end of left toe on waking at 4.45 AM, in great toe when moving and walking.

Generalities.
      Emaciation and decrepitude.
      Trembling.
      Pains (especially of head) temporarily better by turning mind to another topic.
      Feeling as if drug descended and impressed lower part of system, causing trembling of abdomen and lower limbs and blood-vessels connected therewith, but on descending stairs the drug seemed to come upward through the circulation, reaching the brain, causing exhilarating dizziness and disposition to swing and stagger, as if under the influence of liquor, felt talkative and happy, after the dizziness felt a "toned-up" condition of brain and nervous system, dizziness returned on beginning to move.
      Nervous system strung up to its highest tension.
      Stimulating and sedative effect, the sweat.
      Vigor, all day, with exhilaration, next day feelings varying and generally depressed.
      Uneasiness and weakness during day, with timidity and apprehension.
      Weakness in morning, better rising and moving around.
      Want of tone and life in all functions towards night.
      Worse in open air and on motion.

Skin.
      Covered as in leprosy with large scales, which fall off and leave white spots, and these often become ulcers.
      Dryness, especially where it is thick, as on hands and feet, with scales, cracks, and ulcers.
      Painful hard swelling in lower corner of left ear, red, painful lump, threatening to become an abscess, on forehead above right inner canthus and on back.

Sleep.
      Sleepiness: at ten PM, soon afterwards liveliness and wakefulness, irresistible.
      Head sleep several times a day.
      Stupid sleep.
      Heavy sleep with disturbing but unremembered dreams.
      Sleepless, from 12 till 2.30 AM, at four AM, after an emission, then sound sleep, next night wakeful after an emission till I got up for breakfast, latter part of night, mind working on business problems, next morning tired feeling before and after rising.
      Difficult falling asleep.
      Restless sleep last part of night.
      Fragmentary sleep last part of night.
      Fragmentary sleep from 12.30 till 4.20 PM, with varied and exciting dreams, then sleeplessness so that I had to get up at 4.30 AM, did excitedly all kinds of unusual office work.
      Dreams: curious, nonsensical, wild, amorous, of travelling by rail, active, vivid, last part of night, alternating with half-conscious waking, in afternoon, of fighting unknown men, left them to follow an unknown woman, and when she left me found that she had conducted me to a prayer-meeting, which must have changed to a restaurant, for I ordered a Hamburg beefsteak, but woke before it was served, of a fire, heard the engines and firemen.

Fever.
      Chilliness for the last few hours, at eight PM
      Heat: at nine AM, flush of general heat, in face and hands, worse left hand, flushing, in cheeks, heat in left ear-flap and left hand, over upper part of body in evening.
      Hands sought cool places, otherwise no perceptible increase of heat.
      Heavy perspiration, with great dryness of mouth on waking from afternoon nap.