Phytolacca — Homeopathic Remedy Profile

Phytolacca decandra, the American poke root of the Phytolaccaceae family, gives the materia medica one of its principal glandular and rheumatic remedies. It runs from mother tincture and low decimals for herbal work to 30C and above in classical prescribing. Its field is the right-sided sore throat that turns dark red, the hard hot breast of a nursing mother, and the wandering joint pain that flies from place to place before rain.

At a Glance

Source and Preparation

The tincture is made from the fresh root dug in winter, from the ripe berries, or from the fresh leaves; a solution of the resinous extract, phytolaccin, is also used. The ash of the plant runs to about 45 percent caustic potash, and the root contains phytolactic acid, closely allied to malic acid. Young shoots, extremely acrid raw, are rendered harmless by boiling and eaten like asparagus in the United States. The berries of the related Phytolacca octandra are used in Mexico and the West Indies as a soap.

The plant is genuinely toxic in crude quantity. A family of four was once poisoned by eating the root in their food by mistake; the mother, seven months pregnant, nearly miscarried, with the uterus felt to be contracting under the hand and involuntary hemorrhage from the vagina. A woman of forty-five took the plant as a "blood purifier" and developed a general rash resembling the eruption of secondary syphilis. Both incidents belong to the herbal register — tincture and the low decimals, where the alkaloids and phytolactic acid are still present. They do not apply to the classical potencies from 30C upward, where no molecule of the plant remains and what acts is the dynamic preparation, prescribed on the totality of the case. Every safety observation below should be read with the potency in view.

The Essence of Phytolacca

Phytolacca meets the self-governing principle in the tissues where fiber binds to fiber: the sheaths and fascias of muscle, the periosteum, the mucous coverings of throat and digestive tract, and the glandular apparatus of neck, axilla and breast. The picture is one of hardening. Glands enlarge and become stony. Breasts feel like cement. Tonsils turn dark red, the mouth fills with tough stringy saliva, and the tongue takes on a fiery red tip against a yellow-coated base.

Alongside the induration runs its opposite. Pains come and go in quick succession, shift place, and fly like electric shocks along a limb, leaving the part numb, heavy and powerless. Each fresh pain draws a groan. The body feels beaten all over, yet is intolerant of touch. Prostration is deep. The self-expressions of the organism take on this double character throughout: what is fixed hardens further, what is mobile darts.

Where the remedy is well chosen, the discharges become watery, shreddy and stringy. Stools, menses, expectoration and leucorrhea all take that thread-like quality as the tissue reopens and pours out what it had been holding.

Clinical Portrait

Mind and Temperament

The Phytolacca patient is irritable, nervous and restless, but averse to mental exertion and disgusted with the day's business. Melancholy and indifference to life settle in during the illness. There is weeping at night during menses, depression of spirits with headache, and — most characteristic — a great fear of dying, sometimes an outright prediction of death, especially in the mother whose breast is inflamed. On waking, the patient desires death.

Sensitivity to pain is extreme. Pain becomes intolerable to the point of unconsciousness. One striking mental note in the source is a loss of personal delicacy, a complete shamelessness and indifference to exposure of the body — a decomposition of the ordinary reserve that follows on prostration and delirium. Confusion is worse sitting, better in the open air.

Throat and Tonsils

The throat is Phytolacca's most familiar terrain. The fauces are dark red or bluish-red, the tonsils swollen — especially the right — and the pain shoots from the root of the tongue into the ear on swallowing. The patient describes a red-hot ball, or a red-hot iron, in the throat. Swallowing warm drinks is unbearable; cold drinks bring relief, and hot food or drink cannot be got down at all, provoking choking. Empty swallowing hurts. This right-sided sore throat, aggravated by warm drinks and eased by cold, invites comparison with Lachesis, which shares the intolerance of hot drinks and the dusky hue but tends left-sided and left-to-right in extension.

Pseudo-membranous exudation appears grayish-white, thick and tenacious. White or gray patches sit on the tonsils, the breath is offensive, and the tonsillar crypts may look ulcerated. Cervical glands enlarge and harden alongside the throat inflammation; the two symptoms belong together, and when they arrive together they name the remedy. See tonsillitis and sore throat for the field of application.

Clarke used Phyt. 30C for the sore throat of diphtheria; Nash relieved chronic follicular pharyngitis in public speakers who felt a hot substance sitting behind the palate.

Breasts and Nursing

No remedy stands closer to the acute troubles of the nursing woman. The breast is heavy, stony and hard, swollen or tender, with severe stinging pains throughout and milk oozing out; pressure with the hand relieves. Mastitis appears from taking cold, in pregnancy, and after weaning, and the affected breast has a purple hue. Milk is thick, scanty, unhealthy, dries up too soon; and the breast after weaning may remain hard as a stone.

The keynote every practitioner remembers: when the child nurses, the pain travels from the nipple all over the body. Nipples crack, are exquisitely sensitive, and are often inverted. Abscess, bloody or watery discharge, and affections of old scars in the breast all belong here.

The remedy reaches further into breast pathology than any acute prescriber's use suggests. Murphy lists tumors or hard nodes of the breast with enlarged axillary glands, hard nodules with a bluish appearance, scirrhus tumors hard like cement, Paget's disease, and cancerous breasts that suppurate with horrible burning pains. Nash reports removing many breast tumors by a single dose of Phyt. 100,000C given during the wane of the moon, an idiosyncratic and specific observation preserved in the literature. Advanced cancer belongs with the practitioner, not with the home prescriber.

Related and useful in adjacent territory: breastfeeding troubles where the milk goes wrong, and postpartum states with poor recovery.

Limbs and Rheumatism

Rheumatic pains are worse in the morning, tend to affect the outer aspect of the limbs, and shoot from sacrum down the outer thigh to knee and toes. Pains fly like electric shocks; they shift, they wander from one joint and place to another with swelling and redness, and each movement elicits a groan. The affected leg becomes numb, heavy and powerless. Joints swell before a storm or in damp weather.

The shooting pain in the right shoulder, with stiffness and inability to raise the arm, is a familiar prescribing image, and comparison with Rhus-tox is inevitable. Where Rhus-t. is worse first motion and better continued motion, Phytolacca is worse motion throughout, restless yet afraid to move because motion aggravates. The tendons feel too short, a sensation shared with Ruta.

Sciatica with sharp cutting pain in the hip and down the thigh, aching in the heels relieved by elevating the feet, painful hard shiny swelling of finger joints, and stiff neck (especially on the right) all belong to the picture. See sciatica and arthritis for the wider fields.

Two curious notes deserve holding onto. When pain in the intestines disappears, pain in the limbs comes on. Pains leave the heart and appear in the right arm. The illness translates from cavity to periphery, or from viscus to muscle, as though the same disturbance were changing address.

Head, Face and Teeth

Frontal headache is pressive, involves the eyes, and is worse on the right side, with an increased sense of hearing accompanying it. The brain feels bruised. Rheumatism of the scalp brings pains that arrive every time it rains.

The face is pale, hippocratic, yellowish and sickly, with blueness around the eyes. Jaws ache as in mumps; the parotids are tense and pressed, and the glands swell at the angle of the jaw. Phytolacca sits in Murphy's clinical list for mumps in its own right, alongside its throat and gland action.

The teething picture is exceptionally clean. Difficult dentition is better from biting on something hard, and the child has an irresistible desire to bring the teeth or gums together. Teeth feel sore and elongated. Colic during teething, with clenched teeth and severe abdominal cramps and diarrhea, is a Phytolacca picture; see teething and colic.

Stomach, Abdomen and Rectum

Hunger returns soon after eating; there is heat and cramping in the stomach and coldness beneath. Vomiting is violent, sometimes of clotted blood and mucus, and the patient desires death to relieve the vomiting — a symptom that reads like exaggeration on paper and like a plain description at the bedside. Diarrhea after lemonade is a specific note. Stools are thin, dark brown, or pass only mucus and blood or matter that looks like scrapings from the intestines. Dysentery, bleeding hemorrhoids, fissures of the anus, and continuous urging to stool even in sleep all belong. See diarrhea, hemorrhoids and anal fissure.

Chronic hepatitis with enlarged, indurated liver is a clinical field for the remedy; liver pain is worse lying on the right (painful) side, spleen pain better lying on the left (painful) side — a small but useful modality inversion.

Skin, Glands and Ulcers

Skin becomes dry, harsh, shriveled, pale. Erythematous blotches, slightly raised and pale red, end in dark red or purple spots. The disposition to boils and carbuncles, with swollen glands and burning pains worse at night, is a real Phytolacca signature; painful boils appear on the back and behind the ears. Old scars flare and become painful when the weather changes, a note that draws it into the field of Graphites and Silica for cicatricial tissue.

The remedy is one of the classical prescriptions for ringworm, and it belongs also in barber's itch, pityriasis, squamous eruptions and syphilitic eruptions. Cancerous ulcers, chronic ulcers surrounded by boils, and lupus of the nose are all recorded. Externally, an ointment or juice of the leaves has been used for malignant ulcers in humans, and a leaf preparation has been employed on cancerous growths in dogs.

Glandular swellings and indurations sit at the center of the picture: cervical, axillary, parotid, testicular, ovarian. Venereal buboes, painful induration of the testicles, and orchitis (acute and chronic, with suppuration) belong to the male field.

Female and Male

In women, menses are copious and frequent, followed by leucorrhea that is thick, tenacious and irritating. Dysmenorrhea in barren women with erosion of the cervix, ovarian neuralgia of the right side, and ovaritis with rheumatic complications complete the picture; see dysmenorrhea. In men, the shooting pain along the perineum to the penis, painful induration of the testicles, and gonorrhea with gleet and ulcers on the genitals mark the remedy.

Modalities

Worse:

• Exposure to damp, cold weather, rain, cold nights, changes of weather
• Movement; raising up; stepping down from a high step
• Right side
• Touch
• During menses
• Swallowing, particularly of hot drinks
• Heat; warm drinks
• Pressure on joints and ulcers
• Riding (aggravates nose and breathing)
• Night

Better:

• Warmth, dry weather
• Rest; lying on abdomen or left side
• Cold drinks (throat)
• Pressure with the hand (breast pain)
• Rubbing (hip pain)
• Elevating the feet (aching heels)
• Open air (mental confusion)
• Biting on something hard (dentition)

The apparent contradiction between worse from warm drinks and better from warmth generally resolves at the bedside. Warm drinks aggravate the throat specifically; warmth of the body and dry weather ease the rheumatic and glandular pains overall.

Relationships

Antidotes: milk and salt; Belladonna; Mezereum.

Compare: tincture of Phyt. berry for sore throats and for reduction of obesity; Bryonia for the hard, heavy, painful breast in mastitis; Rhus-t. for the wandering rheumatic pains that alter with weather; Kali-carbonicum for the sensation of a red-hot substance (Kali-c. in the rectum, Phytolacca in the throat); Mercurius solubilis in syphilitic bone-and-throat states; Conium for hard glandular tumors.

Inimical: Mercury. The remedies are directly opposed in action; mercurial ptyalism figures in Phytolacca's own picture as an effect it is called on to reverse.

Constitutional field: rheumatic or syphilitic subjects, sensitive to damp weather; the cancer constitution.

Clinical Uses

Tonsillitis and quinsy

The signature picture is a right-sided tonsil, dark or bluish-red fauces, shooting pain from root of tongue to ear on swallowing, aggravated by warm drinks and empty swallowing, relieved by cold. Cervical glands enlarge alongside. Where the picture matches, 30C every two to three hours in the acute phase is common; higher potencies (200C, 1M) are used when constitutional features are present. In diphtheritic sore throat, Clarke's use of 30C is the anchor. The wider prescribing field is developed on the tonsillitis page.

Mastitis and cracked nipples

The hard, hot, purple breast with milk oozing under pressure, the pain that shoots from nipple all over the body when the child nurses, the mother who fears she is dying: this is Phytolacca. Mastitis from cold, mastitis in pregnancy, blocked ducts, cracked and inverted nipples, milk that dries too soon or turns thick and lumpy. The field is wide, and in this field the remedy is often first choice. 30C two- to four-hourly is a common acute schedule; when suppuration threatens, a single higher dose may be indicated on individualized grounds.

Wandering rheumatism, sciatica and stiff neck

Pains that fly like electric shocks, joints that swell before a storm, sciatica shooting down the outer thigh, stiff neck worse right, tendons that feel too short. Worse motion, worse damp, better warmth and rest. 30C or 200C according to the patient and the case.

Influenza with body ache

The influenza with general body ache, back pain, wandering joint pains, and swollen tender glands with throat symptoms is Phytolacca's ground. Fever with pain and vertigo, apathy and internal shivering echo Gelsemium; the sore, bruised feeling echoes Arnica and Bryonia. Where the throat and glands lead, Phytolacca leads. See influenza.

Obesity

The Phytolacca berry's old reputation as an anti-fat remedy rests on a rustic observation: pigeons and other birds that eat the berries lose fat and turn red. American dairymen used the root to regulate cows' milk. In the classical repertory the remedy is listed under obesity, and modern prescribing continues its use in weight management, most often as tincture or low potencies in the herbal register, occasionally as 30C on constitutional grounds. As with any weight prescription, the totality of the case governs, and the berry's herbal use should not be confused with a classical potency's action.

Frequently Asked Questions

What is Phytolacca homeopathic medicine used for?

Its principal fields are the right-sided sore throat and tonsillitis with dark red fauces and pain shooting to the ear on swallowing; mastitis and painful nursing with hard, hot, purple breasts and pain radiating from the nipple all over the body when the child feeds; wandering rheumatic and arthritic pains that fly like electric shocks and are worse in damp weather; and glandular swellings of the neck, axilla and parotids. It is also used for influenza with body ache, difficult dentition with the desire to bite hard on something, ringworm and chronic ulcers, and, in the herbal register, as a traditional aid to weight reduction.

Which potency, and how often?

For acute conditions such as tonsillitis, mastitis and influenza, 30C every two to four hours until improvement is a common acute schedule, reduced or stopped as the picture clears. 200C is used less often and generally with individualized prescribing. Higher potencies belong in constitutional or advanced work. In the herbal register (as a bitter and glandular alterative, or for weight) the mother tincture and low decimals such as Ø and D1 to D6 are used in drop doses. That mode of prescribing is different in kind, and crude-substance cautions apply to it.

Is Phytolacca safe? The plant is toxic.

The distinction is entirely one of register. Crude poke root and berry are toxic; families have been poisoned and pregnancies threatened. That toxicity belongs to the herbal preparation, tincture and the low decimals, where the alkaloids and phytolactic acid are still present. From 30C upward no molecule of the plant remains, and dose-based toxicity cannot apply; what acts is the dynamic preparation, prescribed on the totality of the case. The herbal preparations are not for casual home use.

Can Phytolacca be used for cracked nipples during breastfeeding?

Yes, and this is one of its best-known clinical fields. The specific indication is cracked, exquisitely sensitive or inverted nipples in a nursing mother, especially when pain radiates from the nipple all over the body as the child feeds. 30C two- to four-hourly is a common acute prescription. Where the breast itself is hard and hot and the pain is relieved by pressure with the hand, the same prescription covers both.

References

• Boericke, W. Pocket Manual of Homoeopathic Materia Medica with Repertory. Boericke & Tafel, various editions from 1901. Phytolacca decandra: tincture and all potencies; throat, breast and rheumatic keynotes.
• Clarke, J. H. A Dictionary of Practical Materia Medica. Homoeopathic Publishing Company, London, 1900–1902. Phytolacca decandra: gargle in throat cases; 30C in diphtheritic sore throat; extensive throat and breast indications.
• Murphy, R. Nature's Materia Medica. Lotus Health Institute, third edition. Phytolacca decandra: source of the clinical, mind, breast, throat, limb and modality material summarized here.
• Nash, E. B. Leaders in Homoeopathic Therapeutics. Boericke & Tafel, Philadelphia, 1899. Phytolacca in chronic follicular pharyngitis of public speakers; the single-dose 100,000C note in breast tumor.
• Phatak, S. R. Materia Medica of Homoeopathic Medicines. B. Jain Publishers, New Delhi. Phytolacca decandra: concise clinical and modality summary.