A proving of colchicum autumnale

A proving of Colchicum autumnale J. R . R A E S I D E ,

M.B., C n . B . , M.F.HOM.

The drug proving which was conducted in the year 1964-65 was on the pIanr Colchicum autumnale--the autumn crocus. I t was a re-proving of an old wellknown remedy which had been tested in various forms by homceopathic doctors during the last century. Most of these were single provers or experimenters using concentrated tinctures or infusions, although some kind of short proving had also been conducted. I n recent years a great deal of orthodox research has been done on the alkaloid colchicine obtained from Colchicum, and partly for this reason it was thought that we should do a modern proving. Another reason which prompted us was a desire to extend our knowledge of lesser known rheumatic and arthritic remedies, since this is one of the main diseases we are faced with in practice. I t is also a very poisonous p l a n t - - m a n y cases of accidental poisoning have been recorded--and it is often the most powerful poisons which make the best remedies. For our proving we had the assistance of 17 volunteers--10 men and 7 women. We carried out three separate provings as usual, using 30c, 6x and 6e thus: 1st term Nov 1964 30c 16 provers 2nd term Feb 1965 6x 16 provers 3rd term May 1965 6c 9 provers Each test experiment lasted about two weeks, with 28 powders given and these to be taken night and morning. The potencies were supplied by A. Nelson & Co. and were made by them from a corm (or bulb) of Colchicum autumnale collected in the autumn, after the flowering, when the alkaloid colchicine reaches its greatest concentration. Provers are warned to stop taking the powders if symptoms become too disturbing. A few of them had to stop as usual, one from a severe headache, one from great weakness of limbs and one from pruritus ani. The greatest collection of symptoms came during the first term, to our considerable surprise. The first term is usually the least harvest of signs and symptoms, and the third term is usually the most. Quite the reverse happened here, as it was the autumn term on 30c which was most effective; the second term was quite productive, but the last term was a very poor experiment. One cannot help wondering whether the autumn crocus acts better as a remedy and as a posion in the autumn, for this was certainly the time which produced most results in our provers. NATURAL

HISTORY

Colchieum has many common names including meadow saffron, tuber root, naked lady and upstart. There are about 50 species of the genus. I t belongs to the Melanthaceae group of the lily family, which contains also Veratrum album and viride and Sabadilla.

A PROVING

OF C O L C H I C U M

AUTUMNALE

87

I t grows widely over Europe and Asia, and derives its name from Colchis-a mountainous district on the east coast of the Black Sea. The Greeks regarded Colchis as a special domain of sorcery. This was the home of Medea the sorceress and the destination of the Argonauts in their search for the Golden Fleece. I t was from the East that Colchicum was introduced as a cure for gout into the Byzantine Empire. About 600 A.D. the great physician Alexander of Tralles mentioned Colchicum in this respect in his textbooks of medicine. Whether the early Greeks knew it is in some doubt although it may be that their Hermodactyles (Mercury's fingers) was Colehieum. I t seems that there is some confusion in ancient writing between this and the white hellebore. All through the Middle Ages Colchicum had a fluctuating career as a treat, ment for a long list of ails including gout, cholera, fevers, syphilis, convulsions, asthma, leueorrhoea and many other diseases. Around 1650 Culpeper used it for tertian ague, as a purge and as a diuretic. Some physicians who feared its poisonous effects would apply the macerated root as a plaster to gouty joints. At the beginning of the last century Colchicum enjoyed great success and popularity as a gout cure in the form of "Eau d'Husson" a patent medicine: introduced by a French quack! As a result of this medical interest quickened and it was not long before Pelletier and Carentau isolated the active alkaloid eolchicine in 1820. The strange thing about Colchicum autumnale of course is the fact that the flower blooms in September and October, while the leaves only come up the following spring. The bulb of this crocus is not laminated like an onion but is a solid outgrowth of the lower stem and is called a corm. A new corm appears on the side of the old one in June and grows bigger till autumn when it sends up its tubular pale lilac coloured, six petalled flower or flowers. These wither soon and leave the seed capsule to mature unopened during winter. Next spring the long strap-like leaves come out alone with the seed capsule which is ripe by June. The corm now withers away and is replaced by a new one which grows out of its side. Each corm lasts about three years before disappearing. The juice of the corm is a milky substance which has a bitter taste. For medicinal purposes the corm is normally gathered in autumn but some authors recommend spring or June as the best time. The seeds, which are alse poisonous, can be used as a medicine. The principal constituents of the corm are starch, gum, sugar, tannic acid~ the alkaloid colchicine and a small amount of related alkaloids. PHARMACOLOGY

In both acute and chronic poisoning there is a latent period of some hours before symptoms come on, regardless of the size of the dose. Acute poisoning shows the effect of the alkaloid on the nerves of the gastrointestinal system--nausea, vomiting, diarrhoea, distension, pain and bloody stools, also dry mouth, throat and skin. The kidneys are affeeted--oliguria and haematuria. There is also muscular depression with great weakness. Finally an ascending paralysis with consciousness maintained to the end in most victims, death taking place in 24-48 hours or so. Chronic poisoning demonstrates the ubiquitous action of this substance. The numerous effects include lowering of body temperature, vaso-constriction resulting in elevation of blood pressure, depression of respiratory centre. On the bone marrow it produces a leucopenia followed by a leucocytosis, then

88

THE

BRITISH

HOM(EOPATHIC

JOURNAL

agranulocytosis and finally aplastic anaemia. I t has a depilatory effect (like arsenic and selenium). Then it is a mitotic poison--inhibiting cell division or slowing it greatly, in all cells including neoplastic cells. For this reason it has been used to treat certain sarcomata. I n the same way it can double the chromosomes and so alter the genetic pattern in plants for example. Although colchicine is almost a specific cure for gout, its mode of action is even now not understood. I t is not an analgesic, as it helps no other pain. I t is not anti-inflammatory in any other disease. I t is not a diuretic. I t does not alter the blood uric acid nor the uric acid excretion. I n 95 per cent. of gout patients it can have a dramatic and selective effect on the hot, red, painful joints, causing them to subside in 12 hours or so. But the therapeutic effect quickly slips over into a toxic effect with nausea, vomiting etc. REVIEW

OF

OUR

PROVING

The proving which we have just conducted produced some wonderful symptoms notably in the gastrointestinal system and in the limbs, and to a lesser extent in the realm of mentals, head and heart. Firstly the DIGESTIVE SYSTEM--15 of 17 provers had something to record here in the first or second term, i.e. with 30c or 6x, and not so much with 6c. Altogether 6c was not a good potency in our experience--perhaps because it was the summer term, May-June. As m a n y as 12 had some form of diarrhoea, yet 4 had constipation, which just goes to show that any drug can do a n y t h i n g - or so it seems! Anorexia, nausea, heartburn, vomiting were all mentioned as stomach symptoms, and in the bowel--pain, distension, rumbling, loose stools, sometimes urgent desire and accompanied b y offensive flatus. e.g. " e m p t y feeling in the stomach with rumbling in the abdomen and loose stools worse at night. Urgent desire for stool--fluid yellow painless" on 30c. or " e m p t y feeling in the abdomen, with acidity, heartburn and loose bowels" on 6c. There is no doubt about its effect in this sphere. EXTREMITIES. Here 14 of the 17 had symptoms, mostly with 30c, only a few with 6x and 6c. Thirty-six symptoms in all. Six provers had involvement of small joints. Six had shoulder pains. Three had pains extending down the arm to the hand or fingers. There was a slight preference for the L. side but no other constant modality of time or movement, as both < rest and < movement were recorded. General muscular pains and weakness also occurred. e.g. "ache in L. shoulder and neck, arm to wrist and fingers." or "sharp pain in L. upper arm < movement." MENTALS. Ten provers had mental symptoms, mostly poor mental concentration, depression, lethargy and tiredness---quite the reverse of the intact mentality of the poisoned subjects! The second term on 6x produced most of these symptoms surprisingly. There were, as usually happens, changes in the mental state in the first few days. E.g. "mind very active and clear" on the third day of first term (on 30c), and on the fifth d a y - - " c o n c e n t r a t i o n difficult". This shows the primary effect and secondary effect a few days later. One interesting

A PROVING

OF

COLCHICUM

AUTUMNALE

89

mental produced on 6x w a s - - " o d d feeling as if mind is a jig-saw puzzle with all the pieces there but not interlocked." HEAl). Ten people had vertigo, but this was related to the alimentary symptoms in many of them. Sixteen provers had headaches, most with the 30c. These were frontal, and on the temples or over the R. eye ~ a.m. The best (or worst) headache recorded was--"dull persistent headache on temples in a.m.". This was on 6x and he had to stop proving after 12 days. He had the same pain on 30e in the first term and also to a lesser extent on 6e. HEART AND CHEST. Five had palpitation, one with an irregular heart beat. Two had oppression of heart and chest and 3 had pain in heart or chest. EYE symptoms were negligible--tired, aching, burning eyes, with soreness of lids. MOVTH. Three had mouth ulcers, again related to their G.I. symptoms. THROAT. Similarly 6 had dry throats. SKIN. There were two interesting symptoms but not, unfortunately, concerned with hair! One girl noticed that an old scar on her finger became smaller during the second term {6x). One of the men had most disturbing pruritus ani during all three provings. I t began on the ninth day of 30e; second day of 6x, and was so severe he had to stop the proving for a time. I t was slight with 6c, but still present. He had never had it before. s L E S P was disturbed by silly dreams in a few. GENERALS. Mainly weakness, tiredness and aching of the whole body. One man recorded that he felt fit and alert on the third day of 6c, but in two days time he had a pain in the neck and diarrhoea. Another prover felt generally fit on 30e, but developed general lethargy on 6x, and general malaise on 6c. Yet another said on the third day of 6c: "developed great weakness of limbs and an empty feeling in the abdomen with palpitation of heart---had to lie down in the afternoon". COMPARISON

WITH

PREVIOUS

PROVINGS

Allen's Encyclopaedia lists no less than 85 references to studies of the action of Colchicum. Many of these are single cases of poisoning, or single experiments with concentrated tincture or preparations of the corm. Hahnemann is mentioned in the list of authors, but it is not clear whether he did in fact conduct a trial of Colchicum. Sehroff, Lindemann and Staff all seem to have carried out provings using potencies between 3x and 15x. When we tried to compare our recent work with the drug picture which has emerged from all these poisonings, provings and other experiments, it is immediately obvious that the main characteristics of Colchicum were brought out by our experiments. Most outstandingly the autumn diarrhoea with nausea and distension. Nash stresses the autumn diarrhoea with great nausea and

90

THE BRITISH

HOM(EOPATHIC

JOURNAL

sensitivity to smells. Margaret Tyler mentions the use of Colchicum for the treatment of cattle with bloated abdomen from eating too much clover. Secondly the rheumatic and arthritic pains in small joints appeared in our proving, although the important modality ~ movement ~ rest was not invariably present. Again the mental symptom of hypersensitivity appeared in many in the first few days of our proving, although no one had acute sense of smell. RELATED

REMEDIES

Melanthaceae

Colchicum autumnale Helonias Sabadilla Veratrum alb., nig., viride Yucca Helonias acts mainly on the uterus. Sabadilla is used for hay fever, and has a complicated drug picture not well worked out. I t does not seem to resemble ColchLcum on any point except vertigo which is a common symptom in both drugs. Veratrum alb. has violent diarrhoea similar to Colchicum. Some ancient writers seem to have confused these two plants. Verat. vir. and nig. have few points in common. Yucca--as far as one can see from the few symptoms available--resembles Colchicum in its action. DISCUSSION

There are few plants in the materia mediea which have such a long association with a specific disease as Colchicum has had with gout. For over thirteen centuries the relationship has been recorded and for more centuries still it was probably known. Like many real cures the origin is shrouded in mystery and linked with magic, for in pre-Christian Colchis there was a centre of spiritual teaching from which undoubtedly this medicine came. I t seems reasonable that the Byzantine learned men of medicine took much of their wisdom from the adjacent Near East schools. One of the gifts from the East was Colchicum and its use in gout. During the millenium following its introduction to Europe Colchicum suffered a fluctuating fate of popularity and abandonment, depending upon whether its therapeutic or its toxic effects were more observed. The problem of its toxicity remains today, as indeed it does with many other drugs, although the preparation of its alkaloid colchicine and exact calculation of the therapeutic dose is established with reasonable certainty. Exhaustive research, which in the past twenty years has reached mountainous proportions, has not yet established the exact mode of action of colchieine in gout. We are still left with the question of where and how it acts as a remedy. To Nicholas Culpeper in the 1650s this was less of a problem, for he states boldly that the Meadow Saffron is under the government of Saturn! However much this may have meant to him it means little or nothing to modern man. Another problem faces us each time we think of the autumn crocus as a flower. Such very strange behaviour must mean something--to flower so late in the year and before producing leaves. I f we look into this open secret of nature could we not read its signature? In the Brit. Horn. J. of April 1958, Dr. KSnig gave a long account of Colchicum, describing and discussing it from many aspects. He tried to build up a real drug picture, and to explain why this

A P R O V I N G OF C O L C H I C U ) I A U T U M N A L E

91

flower behaves as it does and why it acts so as a poison and remedy. He sees in the untimely autumn appearance of the Naked L a d y a clue to the mystery. Colchicum is for KSnig a female plant and a cure for an essentially male disease - - g o u t . This is a most imaginative a t t e m p t to grasp the inwardness of the remedy. Whether we understand Colchicum in this way or differently we cannot fail to see in this peculiar poisonous plant a wonderful homceopathic remedy, not for gout alone but for a wider range of disorders, as has been demonstrated anew by our drug proving. This research was again supported b y the Lawson Tait Memorial Trust with a grant which is used to remunerate the student volunteers, without whose help no provings could be carried out. We are most grateful for all this help for Homceopathy. BIBLIOGRAPHY Eigsti, O. J., and Dustin, A. P., Colchicine in Agriculture, Medicine, Biology and Chemistry. Copeman, Short History of Gout. University of California Press. KSnig, K., "Indian Summer, the Autumn Crocus, and Colehicine", Brit. Horn. J., 47, 102. April 1958.

THE

PROVING

SYMPTOMS

OF COLCHICUM

MENTALS

Poor mental concentration (5) Mind like a jigsaw puzzle, not interlocked Mind very clear (on third day) concentration difficult (by fifth day) Mental lethargy (3) Tired and forgetful Tired and depressed (3) Irritable and depressed Worried and depressed Despondent Nervous excitement Indifferent or anxious over nothing

HEAD

Vertigo and faintness (10) Frontal headache and in L. temple ~ a.m. (9) Dull headache in temples, persistent and hammering ~ a.m. (had to stop the drug) Headache over R. eye or L. eye Headache on rising with pain behind eyes and vertigo Occipital headache ) eating H e a v y head Migraine headaches

EYES

Tired eyes Ache behind eyes Soreness and itch round the eyes Eyelids sore and red Eyelids burn Eyes irritate in artificial light,

92

THE

BRITISH

HOMG~OPATHIC

~MOUTH

Ulcers in the mouth Ulcers on tongue and gums Herpes on the lip

THROAT

Dry throat ~ L. Sore throat ~ a.m. Dryness in the nasopharynx Rawness in the throat Difficulty in swallowing

STOMACH

AND

ABDOMEN

RESPIRATION AND

BACK

HEART

AND

NECK

EXTREMITIES

JOURNAL

Loss of appetite Nausea > eating Nausea and sickness after powder Vomiting a.m. with faintness relieved by vomit Feeling of hunger H e a r t b u r n and acidity of stomach Burning pain in abdomen (3) Ache in abdomen < a.m. or in night Ache in abdomen 1 hour after taking powder Pain in abdomen -+ chest Rumbling in abdomen Fullness in abdomen E m p t y feeling in abdomen Loose stools with offensive flatus (6) Diarrhoea (12) Urgent desire for stool--fluid yellow painless Constipation (4) Palpitation and irregular heart beat (5) Oppression of chest and heart (2) Pain in L. chest Ache or stitch pain in heart Stiff aching pain in the back (4) Backache and stiff neck Dull pain in back and kidney region Burning pain in neck L. or R., :> movement Wakened with pain in L. scapula, ~ movement, ~ lying on L. Stiff shoulders Pain from R. shoulder -~ hand or L. arm --> hand Pain in L. axilla Ache in L. shoulder and neck -> arm, wrist and finger Stiff L. shoulder and neck (4) Sharp pain in L. upper arm, ~ movement, ~ rest Dull ache R. arm and L. upper arm Arm feels tight and heavy and tingling, ~ movement Pain in third finger R. hand Cold hands Stiff in L. index finger and L. knee, :> movement, ~ heat

A PROVING

OF

COLCHICUM

AUTUMNALE

Pain in L. buttock Pain in L. hip and leg Ache in L. thigh L. knee stiff Cramp in L. leg in bed Twitching of R. leg in bed Pain and numbness in joints of R. foot Cold numb feet Great weakness of the limbs Muscle pain in extremities General muscle ache especially in back, ~ wet UROGENITAL

M.P. 4 days early Frequency of urination

SKIN

Skin sensitive after shaving Skin burning hot 4 a.m. with no sweating Flushes and sweating Spots on neck and chest Pruritus ani Swelling of an old scar on finger became smaller

SLEEP

Restless sleep (5) Silly dreams Can't sleep on R. side Warm and sweating in night

GENERALS

General fatigue (3) Body tired on waking, must force himself to get up Weak and trembling Feeling of faintness in afternoon Feels easily cold or hot

IMPORTANT

SYMPTOMS

Poor mental concentration Mental lethargy and depression Vertigo and faintness Headache, frontal, ~ a.m. Nausea Abdominal pain Diarrhoea Palpitation and irregular heart Limb pains extending downwards Pain in shoulder and in small joints of hands

5 6 10 9 4 6 12 5 3 8

93