Podophyllum, or rather its resinoid, is classed as a drastic cathartic. Podophyllo-toxin, the active principle of Podopyllum, will cause catharsis when injected hypo-dermically but its irritant effects are such as to prevent its therapeutic employment by this method. Podophyllum in small doses is rather a quick acting cathartic, producing this effect more rapidly than in the case of rhubarb or aloes. Maximum therapeutic doses are followed by profuse liquid stools, accompanied by colicky abdominal pain. Nausea is apt to be an attendant symptom. Larger doses cause enteritis with bloody stools, which may contain the exudative products of the inflammation. The cathartic properties of Podophyllum are manifest after section of the splanchnics and vagi, which suggests that its action is largely peripheral.

In rabbits, slowly poisoned with Podo-phylum tincture, it is found that the large blood vessels of the submucosa and muscular coat of the intestines become congested. There is also a slight sloughing of the mucosa on the surface.

Podophyllum has an action upon the liver; human beings experience, in general, symptoms such as result from a torpid congestion of this organ. In the rabbit this organ is decidedly affected. A typical experiment is as follows: Ten drops of the tincture of Podophyllum were given twice a day for fourteen days, when the animal died from its effects. A general survey of the section shows the larger blood vessels severely congested. There is a fairly well advanced hepatitis as shown by the leucocytes scattered profusely through the tissue. The infiltration of round cells is most noticeable near the center of the lobules, but they have penetrated between the liver threads and cells to the very periphery. Minute droplets of bile are visible throughout the entire section, denoting a bile stasis. The liver cells themselves are beginning to present degenerative changes as a result of the general inflammation.

Therapeutics

Podophyllum: When this remedy is indicated there is present a congestion of the liver and of the digestive tract, and gastro-enteritis is often present. There is sensitiveness of the hepatic region and the patient is found rubbing the part, while the condition is often attended with vomiting of bile. It should be studied in morning diarrhea when the evacuations are sour, green and bilious; there is gurgling throughout the bowels, and then a sudden profuse stool. It should be remembered in cholera morbus and acute intestinal catarrh when the stools are watery, gushing, profuse, green and offensive. There is often a sensation of faintness and emptiness in the abdomen, following stool.

It is indicated in cholera infantum which occurs during dentition, when the stools are green and watery; there is a rolling of the head, grinding of the teeth and whining and moaning during sleep. There is often prolapse of the rectum during stool.

It is of service in congestion of the liver when this organ is enlarged and sensitive. The face and conjunctiva present a yellow, jaundiced appearance. The tongue has a yellow coating and takes the imprint of the teeth. There is an offensive odor from the mouth; during this period constipation is the rule and the stools are clay colored. In other cases, diarrhea may alternate with the constipation; there is jaundice with hyperemia of the liver; fullness, soreness and pain as from gall-stones. Some of these cases are associated with hemorrhoids and prolapse of the anus, which occurs with the stool or from the least motion. It is of benefit in cases of chronic acid gastritis, when there is heartburn with waterbrash and a sensation of heat in the stomach and sour eructations. The patient vomits material consisting of food and mucus which is of an acid character. It is also of benefit in headache of such patients. The headache is of the morning type. There is heat on the vertex, giddiness and dizziness and a sensation of fullness over the eyes; in infants rolling the head from side to side, during dentition, with disturbance of the bowels. The headache alternates with diarrhea.

Characteristic Symptoms Of Podophyllum

1. Bilious conditions in general; congestion and torpidity of the liver; bilious headache; gall-stones with jaundice; bilious diarrhea.

2. Early morning diarrhea; stools green; sour; preceded by colic, especially during hot weather. Yellow stools.

3. Diarrhea during dentition; also with reflex cerebral disturbances, grinding teeth, rolling head from side to side, exhausting stools, hydrocephaloid condition.

4. Grinding of teeth at night; in infants. Infants press gums together.

5. White moist tongue, showing imprints of the teeth. Bad taste in mouth.

6. Faintness and emptiness after stool.

7. Sleepiness in the daytime, especially in the forenoon.