Damiana — Homeopathic Remedy Profile

Damiana (Turnera aphrodisiaca, Turneraceae) is a small aromatic shrub from the arid country of northern Mexico and the American Southwest, taken into the materia medica through Hale in the nineteenth century and preserved for the profession by Clarke. It is prescribed across two registers: as a mother tincture and low decimal drop-dose for genito-urinary debility, and at classical potency for the deeper picture of prostration and reproductive failure after depletion. Its sphere is narrow and its indications are exact.

At a Glance

Source and Preparation

The drug is prepared from the leaves of the plant, tincture of the fresh herb being the classical form, with a tincture of the dried leaves also on record. Murphy lists the historical dose as tincture and all potencies. In practice the remedy is used in two distinct ways, and the practitioner must decide which one is in play before writing a prescription.

At mother tincture and low decimals — Ø, 1x, 2x, up to about D6 — Damiana is a herbal tonic. Real plant material is present, and the pharmacology of the plant, its interactions and its cautions all apply. Douglass's cured case of chronic incontinence, cited by Clarke, was given on Dam. 2x four times daily in water. That is the drainage register, and it is where much of the historical evidence sits.

From 30C upward the material trace is gone, and what acts is the dynamic preparation, prescribed on the totality of the case. Dose-based cautions about the plant no longer apply in that form, because they cannot apply — nothing of the crude substance remains to trigger them. The distinction matters because the two prescriptions look for different things at the bedside: the low-decimal for a targeted organ complaint in an otherwise sturdy constitution, the higher potency for the whole picture of a person emptied out by long depletion.

The Essence of Damiana

The characteristic state is exhaustion of the reproductive and generative sphere, brought on by over-exertion, sexual excess, chronic illness, spinal injury or prolonged depletion, and expressing itself in weakness rather than in inflammation. There is little heat in the picture, little congestion, no violent local disease. What one finds instead is a slow failure of function: erections that will not come, menses that will not appear, urine that will not be held, energy that will not return after ordinary effort.

The Mexican tradition, which Clarke records, described the herb as one that invigorated the system, and reported that a decoction of it was used by the Indians as a great restorer after wearisome journeys, dispelling fatigue when nothing else would. It was given, in the same tradition, for the inability to exercise the reproductive functions in either sex. That double indication — the fatigue of the road and the weakness of the generative organs — is the seed of the remedy's homeopathic use, and it holds.

Damiana does not belong with the fiery, congested aphrodisiacs of the materia medica. It is a remedy of restoration, prescribed where the self-governing principle has been drained and is unable to command its ordinary reactions. Where that reaction can be freed, the response is often prompt.

Clinical Portrait

Mind and Temperament

The mental picture in Clarke's account is spare. What comes through is chronic fatigue rather than acute suffering: a person who has been long depleted, whose nights bring no repair, whose appetite is poor and whose interest in ordinary life is dulled. There is no marked anxiety, no delusional state, none of the vivid affective pictures of the polychrests. The keynote is exhaustion carried for weeks or months, often traceable to a definite depletion — a fall, a fever left untreated, a period of sexual excess, a run of overwork.

The clue is often circumstantial. A man in his sixties who has been dribbling urine day and night for four years, worn down by broken sleep and the shame of soaked clothes, arrives without a striking mental symptom to give. What he brings is fatigue and a story of gradual loss. That was the picture Douglass met and cured with Dam. 2x inside two months, as Clarke reports it: a case with no brilliant modality, but a clear register of long-standing depletion in an organ Damiana governs.

Head

Damiana has an unexpected reputation in migraine. Clarke gathers cases in which one or two doses given inside an hour caused the headache to cease, induced sleep, and left the patient waking free of pain and with appetite restored. The picture is not that of the congested, splitting Belladonna headache, nor the bursting Bryonia head that forbids motion. It is a migraine that comes on in the depleted subject, often the same subject who presents the genito-urinary keynotes, and that answers, sometimes remarkably, to the remedy that meets the whole ground of the case.

Back and Spine

Weakness after spinal injury from a fall stands in Clarke's entry as a specific indication. The trauma need not be recent; what matters is the residual weakness — of the back itself, of the sexual function, of the bladder — that follows an injury the patient has never fully thrown off. Here the remedy sits close to Arnica for the injury itself and to Bellis for its deeper reach into pelvic tissues, but Damiana is the remedy of the sequel rather than of the acute event.

Male Sphere

This is the heart of Damiana. Impotence in the elderly, or in the young after over-indulgence; spermatorrhea; the flat, sluggish prostate that gives no acute symptoms but will not do its work; residual weakness after gonorrhea or syphilis long since gone quiet, where the discharge has ended but the organ remains diminished. The impotence is functional, not congestive: no priapism, no tormenting desire, but a failure to rise to the occasion after a life that has emptied the reserves. Clarke stresses over-exertion and sexual excess as causations, and Hale collected the original American observations that place the remedy in the same field as Sabal serrulata for the prostate and Agnus castus for impotence with cold genitals and mental despondency.

Female Sphere

Amenorrhea, dysmenorrhea and leucorrhea in the depleted subject, with sexual weakness and infertility as the deeper indication. The menses that Damiana meets are those that have failed from exhaustion rather than been driven back by cold or fright. The dysmenorrhea is that of a debilitated woman who has borne children or borne much else, whose periods have grown scanty and painful together, and whose leucorrhea drags on between them without inflammatory heat. Infertility with no discoverable structural cause, in a woman whose whole tone is low, belongs in the remedy's range.

Bladder and Urinary

Incontinence is the leading urinary indication and the one on which the remedy's small clinical literature most clearly rests. Douglass's three cases, all cured, are cited by Clarke; the most detailed is the man of 63 with four years of day-and-night dribbling, cured on Dam. 2x in water four times a day, over the course of two months. The picture is one of atonic bladder rather than of irritation. There is no urging, no scalding, no character of Cantharis; there is failure of hold in an organ that has grown tired.

General

Chronic fatigue underlies the whole. Recovery from over-exertion, from sexual excess, from the sequels of gonorrhea or syphilis, from a spinal injury never quite outgrown. The remedy addresses convalescence more than acute disease.

Modalities

Clarke and Murphy record few explicit modalities for Damiana, and it would be dishonest to invent them. The pattern that emerges from the recorded cases is that of aggravation from what depletes and amelioration from what restores.

Worse:

• Over-exertion, physical or sexual
• Prolonged illness and convalescence poorly managed
• Sequels of suppressed venereal disease
• Old injury to the spine

Better:

• Rest and sleep, particularly the sleep that follows a dose in migraine
• The restoration of appetite

The scarcity of time-of-day and thermal modalities is itself a clue. Damiana is a remedy of state rather than of paroxysm; the case does not turn on whether the patient is worse at 3 a.m. or in a warm room, but on whether the ground of the depletion can be met.

Relationships

Clarke, whom Murphy follows, sets Damiana beside a small number of remedies with which it shares specific ground.

For impotence, injuries and overexertion, Bellis perennis, Arnica and Agnus castus stand closest. Bellis meets deep pelvic bruising and the muscular soreness of the overworked laborer; Arnica meets the injury itself and the sore-lame state that follows; Agnus is the elective remedy for impotence with cold, relaxed genitals and marked mental depression, particularly in men who have exhausted themselves early. Damiana meets the debility that remains once the acute bruise has cleared and once the depression has lifted enough to complain of the failure below.

For prostatic affections, Sabal serrulata and Solidago are the comparisons. Sabal is the standard low-potency remedy for prostatic enlargement with dribbling urine, cold genitals and loss of sexual power, and it overlaps with Damiana at the drainage end of the register. Solidago meets prostatic complaints where the kidney is also involved and the urine scanty and highly colored. Damiana sits between them, with less local congestion than Sabal and less kidney reference than Solidago, but with a stronger note of general fatigue than either.

For migraines, Bryonia and Epiphegus are the compared remedies. Bryonia is the migraine of motion aggravation, dry mucous membranes and pressure amelioration. Epiphegus, the beech-drops of Hale's American materia medica, meets the migraine brought on by shopping, fatigue or unusual exertion — a comparison so exact to Damiana's own field that the two remedies must be weighed against each other whenever the migraine occurs in the depleted subject.

No antidotes are recorded in Clarke's entry, and none should be invented. Complementary use with the prostatic remedies at low potency, and with Arnica or Bellis in the sequel of injury, follows from the sphere rather than from any formal instruction in the text.

Clinical Uses

Impotence and sexual weakness after depletion

The elective use. Impotence in the elderly, in the convalescent, in the man worn down by overwork or by sexual excess, with no marked congestive symptoms and no tormenting desire. The remedy is often given at low potency — mother tincture in drop doses, or 2x to 6x — where a targeted organ effect is wanted, and reserved for higher potency where the whole ground of exhaustion is to be met. Give a course and wait; the response, when it comes, comes slowly.

Chronic incontinence, particularly in the elderly

The historical stronghold of the remedy. Atonic bladder with day-and-night dribbling, no urging, no burning, no character of acute urinary disease. Douglass's Dam. 2x four times a day, in water, was the prescription that carried a four-year case to cure in two months and set the pattern for the remedy's use in this complaint. Cantharis, Causticum and Sepia will be considered first in most incontinence cases, but where the picture is one of pure atony in the depleted subject, Damiana deserves its place.

Amenorrhea, dysmenorrhea and leucorrhea in the debilitated

For the woman whose menses have failed with the general strength; whose periods are scanty, delayed and painful; whose leucorrhea drags on without inflammatory character; and in whom infertility has no discoverable structural cause. The remedy meets the ground rather than the local disease, and its selection turns on the whole tone of the patient rather than on the character of the flow.

Aborting migraine

Given inside the first hour of the attack, one or two doses, in the subject whose migraines belong to the wider Damiana picture — the depleted, the convalescent, the person whose head is the loudest complaint of a general failure. Clarke's cases describe the headache ceasing, sleep following, and the patient waking free of pain and with appetite restored.

Sequel of spinal injury

For the weakness — of the back, of the pelvic organs, of the bladder — that lingers after a fall long past. Not the acute injury, which belongs to Arnica and Bellis and Hypericum, but the residual atony that has outlived the bruise.

Frequently Asked Questions

What potency is Damiana usually given in?

It depends on which register is being used. For a targeted complaint in the drainage mode — Douglass's incontinence case is the model — mother tincture or 2x to 6x, several times a day, is the traditional prescription and the one on which the recorded cures rest. Where the remedy is chosen for the totality of a depleted case, 30C and above are used on the same principles as any other classical prescription. The two forms are not interchangeable and should not be mixed within a single course.

Is the herbal caution about the plant relevant when the remedy is given at high potency?

No. The cautions attached to Turnera aphrodisiaca as a herb concern the plant material and belong to the herbal register at Ø and low decimals, where real dosimetry applies. From 30C upward there is no molecule of the plant present, so a threshold expressed in milligrams of leaf cannot be approached even in principle. What acts at that dilution is the dynamic preparation, prescribed on the totality of the case.

How does Damiana differ from Sabal serrulata in prostatic weakness?

Sabal is the more strictly local remedy: enlarged prostate, cold and relaxed genitals, dribbling with retained urine, sexual power extinguished. Damiana carries a wider ground of general fatigue and reproductive depletion, and is more often indicated where the prostatic symptom sits inside a picture of long convalescence or of exhaustion after over-exertion. In the drainage register the two overlap, and Clarke groups them under the same comparison; classical prescribing will separate them on the whole state.

When should a different remedy be considered first?

When there is acute inflammation, burning, urging, congestion or violent local symptoms. Cantharis for scalding urine and constant urging, Belladonna for hot congested headache with throbbing, Nux vomica for the impotence of the overworked man who is also irritable and sleepless — these are the leading indications that steer away from Damiana. The remedy's sphere is atony, not irritation; where the picture is fiery, another remedy is nearer.

References

Clarke, J.H. A Dictionary of Practical Materia Medica. London: Homoeopathic Publishing Company, 1900. Entry: Damiana.

Hale, E.M. Materia Medica and Special Therapeutics of the New Remedies. Original American source for the drug proving and early clinical use, on which Clarke's entry substantially rests.

Murphy, R. Nature's Materia Medica. Third edition. Blacksburg: Lotus Health Institute. Entry: Turnera aphrodisiaca (Damiana).