CLINICAL AND THERAPEUTICS STUDY OF DRAINAGE : REMEDIES OF THE LIVER AND OF THE BILE DUCT
What conditions before all the homoeopathic remedies in their action on the drainage, is their Tropism, their Local Elective Action and the choice and selection that the human organism makes, thanks to which such a remedy will act on such tissue, such region or even on such part of such an organ (Chelidonium on the right lobe of the liver etc….)
The schema included here : Abdomen, drainage and Canalisation shows the local elective action, on the liver, the spleen and on the different parts of the digestive tract of the principal homoeopathic remedies.
Here is now a classification of remedies that we are going to study and which are the most important for the drainage of the liver and of the gall-bladder.
1. Four principal drainers of the Liver : Solidago, Chelidonium, Taraxacum, Carduus marianus.
2. Six drainers of bile ducts and of the liver : Hydrastis Chionanthus, China, Myrica, Berberies.
3. Four remedies of painful spasms of the bile ducts. Colocynthis, Dioscoria villosa, Bryonia, Chamomilla.
4. Four remedies of portal hypertension and of haemorrhoids in relation to liver troubles : Podophyllum, Aloe, Aesculus hippocastanum, Collinsonia.
5. Four other remedies of hepato-biliary troubles : Ptelia Leptandra, Jugulans cinerea, Yucca filamentosa.
6. Minerals : Eight mineral compounds : Natrum phos., Natrum sulphuricum, Magnesia muriatica, Magnesia sulphuricum, Kali bichromicum, Kali carbonicum, Mercurius solubilis and Mercurius dulcis.
And finally :
7. Two remedies which are to be placed separately for their particular action on cholecystitis, one vegetable and the other from the animal kingdom : Ricinus communis and Vipera.
Some organic substances such as Liver extract, Bile extract, Biliary salts, Calculus biliaris, Cholesterinum, Lecithin, Lutein, and the choleretics and cholagogs described by Charbol, Polypode, Cynara scolymus, Combratum, Boldo, and Rosemary etc.
Finally there exist numerous remedies of Derivation which act not only on the liver but also on the other organs.
Iris versicolor (Pancreas and intracephalic circulation).
Digitalis (heart and kidneys).
Dulcamara (locomotor system and conjunctive tissues)
Nux vomica. Canaliser of Sulphur on the small intestines (Nebel)
Antimonium crudum. Action on the intestines.
Arsenicum album. Universal action. Every age, all the tissues of all organs.
Ceonathus. Principal sphere of action on the spleen.
Sepia. Portal veins and lower abdomen.
Pulsatilla. General venous congestion and troubles due to incomplete digestion of facts.
Cyclamen. For the digestion of fact.
Solidago, Chelidonium, Taraxacum, Carduus Marianus.
Solidago. An important remedy of drainage, indicated tous by Burnett, and we of the French school use it specially; foreign homoeopaths, use it much less. Even we use it as a routine, prescribing it whenever our therapeutic ideas are somewhat vague.
Solidago, though very interesting to use and is of the first importance among the remedies for the drainage of the outlets, is not however the only one and should not occupy an exaggerated place. It is a plant, which grows in the forest and dry grounds. It is not consumed as food, but however one can ingest it in a small quantity without any danger and the cattles often eat them. It blooms in August and in September.
Empirically it is used as a diuretic and you will find in the book on phytotherapy of Leclerc, a small chapter on it, which is interesting to read, but this does not teach us, Homoeopaths, anything, because the Phytotherapaths know much less than us about the plant. Leclerc has however indicated to us that a decoction of Solidago, may give good results in enteralgia, diarrhoea, dysenteric stools with tenesmus and in infantile enteritis during dentition.
It is a remedy that acts by opening the Renal Barrage and secondarily the digestive barrage. It has a very mild action on the liver and also on the lower limbs and on the blood.
The reputation of Solidago comes from the fact that it checks the medicinal aggravation caused by Sulphur, Nux vomica, Lycopodium. It may be related to all the important ground remedies and even to all the medicines of the Materia Medica. It has no incompatibility. Every time you use it for opening the renal barrage and at the sametime you prescribe other remedies, ground remedies and functional remedies, you need not be afraid of incompatibility you may be sure that it will not hinder the action of other remedies. But you must know how to apply it. If you use it in very low dilution, 1x or 3x, you risk an irritation of kidney. If you use it in very high dilution, you will not open the renal barrage. On my part, after number of trials, I have settled on 3x, 5 drops every day before meal at noon. The decoction acts very mildly as diuretic and does not cause dysuria. You may give safely to some persons, a cup of the decoction in the morning. By doing so you will have a very mild action on the kidney and on the liver.
Some homoeopaths with Chiron, have the habit of not giving a high dilution but begins to prescribe at first some remedies of drainage for eight days before giving the high dilution.
Sometimes Solidago will allow you to have a digestive elimination, i.e. it will act mildly on the constipation. But this is not always the case. Sometimes Solidago does not at all act on constipation when on the contrary the urine increases generally. The color of the urine may change. After the prescription of Solidago the deposit in the morning may be abundant.
But this remedy may not be always enough for drainage of digestive apparatus and kidney and you are sometimes obliged to give a functional remedy which will act as a link between the ground remedies and the drainage remedies. This is specially true for Lycopodium. You know that this constitutional or ground remedy causes often some aggravations specially in adults.
In children you may prescribe it without any fear of danger. To an adult it is very often “shocking”. The aggravation is rarely dangerous but sometimes annoying; it is either hypersthenic, or hyposthenic; it may cause spasms like that of Colocynthis or an abdominal distension like that of China. If your Lycopodium subject defends violently, if he is nervous having many mental symptoms of the remedy, an angry person, he may very well, after having the dose of Lycopodium, have on the next day some very violent spasmodic pains in the abdomen, specially with a spasm of transverse colon, and of small intestines; the pain is so violent that the patient is obliged to bend double. In this case, you will give two hours, at the same time as complementary and antidote of Lycopodium, as complementary it follows Lycopodium, as antidote it checks its bad effects.
In order to save your patient from aggravation, you may give one dose of Lycopodium 200 followed by Colocynthis 30, one granule every day. You can prescribe it preferably at 4 to 5 p.m., i.e. to say towards the time of the aggravation of Lycopodium.
Other patients may have distension of the abdomen from the next day, a real general acrocholia, tiresome and painful, generalised meteorism in the whole abdomen. There is a kind of very intense blockage. China, then antidotes the bad effects of Lycopodium and is also a complementary to it.
And if you are afraid that your patient may have both types of aggravation you are quite right to follow your high dilution by Colocynthis 30 and China 30 alternately. Solidago will drain Lycopodium and will be prescribed everyday at noon. This is a very simple formula of drainage in Homoeopathy.
We must recall here that what is remarkable in homoeopathic medicine is that even the homoeopaths who have long experience, do not know how a patient is going to react the first time when it has been prescribed to him.
You may take the entire responsibility of cure in future, but you can never say to a patient who comes to you for the first time : “This first treatment is going to cure you or cause amelioration”. You know nothing. It is impossible to know how a patient will react. One knows it only during the second consultation. There is always an unknown one, only temporarily. This unknown one shows us the necessity of individualising each case and not to give ever a patient a prescription of confection instead of giving him the measured remedy.
There is no doubt that Solidago has the benefit of that reputation to check medicinal aggravation but we must not exaggerate its use and should not use it as a routine. As we have said just now, it opens the renal barrage. The patient micturates better, the eliminations are sometimes more concentrated but very often abundant. Sometimes however after Solidago, the quantity of urine does not increase, but the patient goes well. In the symptoms indicated by Dr. Renard, I believe, it should be insisted when you wish to give Solidago on the symptom of “feeling weak”. The patient, from sometime, feels that he is becoming weak, he is losing his energy in work and his kidneys are sensitive to pressure.
Solidago has a Weihe point situated on the region of right kidney, on the surface of the triangle of Jean-Louis Petit. Sometimes the constipation augments after having taken the medicine specially when the liver is insufficient. One should not be anxious for this, because it seems that constipation at the beginning of a treatment gives for sometime rest to the hepatic cells. There is produced a slowness of the intestinal transit; a diminution of bile secretion, but the overworked liver takes rest, the patient then goes better. Even when the patient goes no more to pass stools and some mechanical means become necessary, he will remain good because his liver will be slow acting.
This is a point on which we have much insisted. There is but one remedy with centrifugal action on the digestive sphere in all the dilutions. It is Taraxacum. Lycopodium is centrifugal only in 6 or 12.
Now we come to the study of Chelidonium, Taraxacum and Carduus Marianus.
We must understand well the action of these medicines of drainage on the liver, because it is their action on the hepatic cells, on the liver itself allows a drainage either towards digestive apparatus, or to the urinary tract.
Imagine to yourself a hepatic lobula. The central vein of this lobula, the lobula itself with its hepatic cells, really called biliary ducts to the periphery. When you use some cholagogs, you act on the biliary ducts i.e. to say on the peripheric part of the lobula; Phosphorus in high dilutions given to a person suffering from insufficient liver, act on the liver, the blood and the kidneys. It is for this reason that Phosphorus is an important remedy of grave insufficient liver and of uremia. As regards the biliary ducts, Lycopodium and Sulphur will be more specially indicated. Lycopodium is a double edged arm; the more you give it in lower dilutions the more it will act on the periphery; the more you give it in high dilutions, the more it will come nearer to Phosphorus. This will help us to understand the chart. On this schema we have put Chelidonium, Taraxacum and Carduus marianus on the left lobe. Schematically, we may say that Lycopodium, Phosphorus and Sepia are the important ground remedies of these three remedies of drainage. Solidago being the drainage remedy of our whole chart.
Chelidonium. It is a remedy of drainage of the digestive apparatus although at first it creates constipation. But it has later on a very mild action on the liver and helps it to act slowly on the digestive apparatus. Carduus marianus constipates less than Taraxacum and helps us to get a rapid drainage acting on the constipation. For this reason, you may very well give to the same person to allay the constipation of Chelidonium, this remedy and Taraxacum alternately. But together they do not go very well.
The big Chelidonium grows in humid ditches, on old walls, in uncultivated places, ruins of rocks. It has alone, among the three remedies, the symptom : Aggravation by every change of weather.
It may therefore be indicated in hydrogenoids and in some cases, Chelidonium may have for its ground remedies, Natrum sulphuricum or Thuja.
The big Chelidonium is used by the empirics for the treatment of epithelioma. What is interesting to recall here, is that it contains some alkaloids, chelidoni acid. These alkaloids and this acid have some narcotic properties analogous to those of papaverine. Both belong to the family of papavericae; this fact explains that often a person, who will die of uremia, will pass through the stage of Chelidonium, before arriving to that of Opium. Chelidonium is a shaded off Opium.
Chelidonium has action on the skin; it is used in the treatment of warts, because it is sufficiently caustic.
Elective Local Action. On an anatomical region. It is not only a remedy which acts on the right lobe but also on the lower part of the hemi-thorax (right) and on the right portion of the right hypochondria which includes the right lobe of the liver, the lower base of right lung, the right pleura in the same region and accessorily on the right thorax. It is for this reason Chelidonium is sometimes given in intercostal herpes.
You see here an example of a remedy which does not only act as tisane or on an organ but on a topographic region and according too metameric distribution. It acts on the right portion of the abdomen; it is therefore a remedy of the right angle of the colon, of the right base of the right lung in some broncho-pneumonias and pneumonias of the right base.
You remember that it acts on the mucous membranes like Hydrastis, specially on those of the biliary apparatus, on the intestinal mucosa and finally it has a secondary action on the kidneys, the knees and on the occiput. A patient of Chelidonium may come to you for his headache on the occiput. You may, in that case think of a liver which is not working well and prescribe Chelidonium or Juglans cineria. In this case often the ground remedy is Lachesis : vertigo, pain of the occiput, gushes of heat, delayed menses or less abundant menses.
Lachnanthes may act electively if there is a rheumatism of the cervical vertebrae.
Action on the knees makes it related to Cocculus. Some patients of arthritis, whose liver works bad, have rheumatism specially of the knees : Chelidonium, Cocculus, Bryonia and Symphytum. The ground remedy will be Natrum Muriaticum and Thuja insufficient liver, arthritis, bad circulation. The toxins are not burnt, toxinic deposition on the articulations. If there is any extra-articular localisation : Bryonia. If there are extra- articular localisations : Rhus tox. With osteocartilagenous lesions: Symphytum. Cracklings in the knees, often with a liver that does not work well, with nausea in a coach or in a train Cocculus.
Do no forget that the vertigo of Chelidonium is related to the liver. The tongue is completely yellow, having imprint of the teeth (Mercurius and Hydrastis)
In Chelidonium : Aggr. by movement, change of climate by touch, cough, the north-east wind; from 4 to 8 p.m. in the evening according to the elimination of urea in the urine.
Do not forget also its relation with Arsenic Album as both like heat, inverse of Phosphorus.
From practical point of view I like Chelidonium as a remedy of Indigestion. When a child or an adult has indigestion caused by fatty foods, it is a marvellous remedy like Antimonium crudum and Nux vomica with which you may give it alternately. The patient complains of his stomach while it is the liver which is affected.
Carduus Marianus. This plant grows in humid places, on the sides of the streets and on ruins. Men rarely eat it. However in some countries where there is famine, people eat this plant.
It is a very bitter plant and as such according to the doctrine of signatures it will act on the liver. This is possible because empirically it is said that the bitter plants act on the liver and on the bile. Carduus is used in precancer stage with high blood pressure. It acts on the liver specially on the left lobe, in jaundice, and empirically on leucorrhoea.
Local Elective Action. Liver, veins, specially portal veins (Sepia) while Sulphur acts on arterial and venous circulation of the abdomen. Nux vomica and Aloe act equally on portal veins; Carduus has a general action on the venous system.
It acts secondarily on the mucous membranes, occiput, kidneys and on the knees but much less than Chelidonium.
The liver is big, often with vomiting of bile.
Amelioration by discharge of blood, agg. by lying on the left side and by beer like that of Aloe.
It seems to act not only on the liver but also on supra- renals specially the left one.
Pre-sternal pigmentation of the skin. This pigmentation in some subjects denotes a diminution of vital force, with supra- renal insufficiency and hepatic insufficiency premonitory symptoms of cancer. It is often an important remedy of female genital cancer.
Taraxacum. This plant grows in the meadows, pasture grounds and on street sides. Cows, goats and sheep feed on them and the bees like very much its flowers. We take it sometimes with salads. It grows on sandy grounds.
Empirically it is said that it is purifier and a tonic but Leclerc says that it is a double edged arm. It may excite or depress and it has been researched what was the number of blood globules before giving M.T. of Taraxacum in high doses; it was seen that at the beginning the number of hematies increases and that very soon, in the second stage the number diminishes. Therefore there is produced at first an excitation and then a depression.
Taraxacum with Phosphorus and Kali Carbonicum acts electively on the supernumerary element of the blood. Kali carbonicum is a remedy that we give in pre-hepatic dyspeptic troubles. This is an ordinary liver in sufficiency for which Taraxacum is an excellent drainage remedy.
Taraxacum contains Calcium, Sodium and Potassium (Calcarea carbonica, Natrum muriaticum, Kali carbonicum).
Among its characteristics let us insist on the Mapped tongue. It is the mirror of all the mucous membranes of the digestive apparatus. It is very difficult to explain it. As in Natrum Muriaticum, one may only say that there is bad elimination on the mucous membranes with often a tendency to blockage of the mucous membranes.
A remedy of pre-cancer of pre-uremic stage.
Local Elective Action. 1. On the Liver, medial lobe, biliary ducts. It is centrifugal because it acts on the central lobe of the liver.
2. On the tongue, blood, hematies.
3. Action on the sternocleidomastoids, that have contractions.
The ground remedies are Lycopodium, Phosphorus, Thuja.
Taraxacum is often a remedy of neuralgia. It acts on the knees but its action is not of any great importance as a local elective action.
Aggr. by rest, sitting or standing.
Amel. by walking and touch.
There may be an abdominal meteorism which makes it related to China. You may give to Phosphorus patient China 30 and Taraxacum 3x.
Much night-sweats, a sign of cutaneous elimination.
Taraxacum seems to bring back a digestive elimination and stops vesical elimination.
An important remedy of indigestion with vomiting of hepato- biliary origin.
Dr. A. Nebel has taught me to application of Peucedenum when in the case of an aerophagia with pyloro-duodenal syndrome, it is necessary to open the renal barrage, when the kidneys are blocked.
Hydrastis. It is really a type of medicine of universal drainage, like Solidago and Berberis. We think of it not only as a drainer of the digestive apparatus, but also of respiratory, genetary, and even urinary systems when it is the question of drainage through any mucous membranes and gland.
One of the most important characteristics is to produce a Discharge of Mucous Extremely thick, Yellowish, Ropy, Tenacious and Adherent.
Its another characteristic is debility and weakness. Hydrastis comes from Canada and we have only few ideas about its empiric use. It was first used by the homoeopaths. It is always the local elective action which makes it a remedy of drainage and canalisation. Action Hydrastis is as follows : 1. Action on the tissues which is very important. Surface action on mucous membranes. On tissues of which the value is schematised by two dimensions and not by three dimensions. Mucous of the stomach, biliary ducts, intestines. Secondarily on the uterine mucous membranes, then on the urethra; finally cavum and the pharynx more than on the bronchial mucous membranes.
2. The really elective action is produced on the Stomach, the Biliary ducts, intestines, cavum and the pharynx. The typical characteristic symptom is always thick, yellow and thready discharge.
The discharge of Hydrastis is very similar to that of Kali bichromicum which is sometimes more corrosive than that of Hydrastis.
The discharge of any mucous membrane happens in this way : 1st Stage. Less abundant, fluid, less coloured and very corrosive of the type of Arsenicum, Mercurius cor. and Nitric acid (mixed with blood)
2nd Stage. Less abundant, thicker, becomes coloured, yellowish or greenish, adherent, ropy, thready.
3rd Stage. Abundant, thick, but non-corrosive (Pulsatilla)
It seems than in the first stage there is some toxic substances because of the corrosiveness of the discharge. This gradually diminishes as the discharge continues and the mucous membrane is repaired.