Vol. 23 No. 2 April 2003

by C. E. Wheeler and J. D. Kenyon

Piper methysticum is a Polynesian plant and from it is made the beverage called kava. It is used as a stimulant and some valuable hints as to its use as a remedy are derived from the result of over-indulgence in it.

The important spheres of action are in the nervous system and skin, both tissues ectodermal in development. But it is by no means a universal rule that effect on the one is always accompanied by effects on the other.

Lewin confirms the nature and occasional severity of the skin symptoms. He also speaks of overwhelming nausea. It should be noted Lewin said the nausea occurred in a case of gonorrhoeal epididymitis. There was no local aggravation of symptoms although our provings contain indications which would suggest that it has a distinct action on the generative system. So it may be that it was a similar in the case described and thereby more likely to bring out extra symptoms.

It is said to be an aphrodisiac in small doses and being botanically allied to Cubeba should be expected to have (as it has) some power not only over the gonads but on the urethra and its neighbourhood.

The skin symptoms form a curious mixture of stimulation of the superficial layers with a general interference with nutrition that leads to a kind of atrophy. Thus the skin as a whole becomes changed as it does with advancing life. It is senile in appearance, less elastic and resilient, but the superficial layer thickens with cell multiplication till it looks like a case of ichthyosis. The skin is dry and covered with large scales which fall off revealing whitish areas which tend to ulcerate.

This condition occurs particularly in those areas where the skin is thick, such as the hands and soles of the feet.

In the special senses there is a tendency to conjunctivitis accompanied by pain and other subjective symptoms, but these are best considered with of the rest of the nervous system.

The mouth and tongue feel a burning sensation followed by numbness. There is often a dryness of the mouth but the reverse sensation of free salivation may occur. Perversion of taste or loss of taste are common (e.g. all food tasting sweet or sharp), but interestingly enough, the appetite is good or even increased. Relief of cases of dental neuralgia are reported where the pain was intense, inducing continuous restlessness and relief was found when the patient’s attention was diverted – a notable modality of the drug.

Digestion is unsatisfactory; sour risings from the stomach and some burning pain and a sense of heat: abdominal pain and colic, worse in the morning, is followed by a loose stool. Otherwise there is constipation in spite of a considerable urging to stool (especially in the evening). In fact, much as Nux vomica, there is evidence of disturbed peristalsis which at times, as in the morning, hurries the bowel contents through in a loose stool and at other times by irregular contraction causes delay and constipation with pain and ineffective urging.

Kava is consumed by more men than women in Polynesia and we have little or no proving from the female sex. In men there is burning felt in the urethra and cures by the use of this drug are reported of cases of gleet, prostatorrhoea and chronic cystitis.

Some joint and limb pains appear and numbness and tingling that are suggestive of neuritis; and the suggestion is confirmed by heaviness and inco-ordination in walking and weakness after muscular exertion. They are probably to be related to the gastro-intestinal symptoms and indicative of changes in bowel flora.

It is, however, the central nervous system which gives us the most important symptoms that most commonly lead to the choice of the remedy. It is the power of attention that is most directly influenced and the signs follow the succession of stimulation and exhaustion which is so frequently observed in drug action and is an exemplification of the so-called Arndt-Schultz generalization governing the action of stimuli.

Thus there is a sense of exaltation and increased mental capacity. Brain exertion seems easy and any mental test is undertaken with confidence. Then there follows a sense of fatigue, inability to concentrate and drowsiness. A certain timidity and apprehensiveness goes with this later stage. In the stage of stimulation there is vertigo and a kind of intoxication. Fantastic ideas prevail and movement is not well coordinated.
Later comes headache recalling the type produced by Lycopodium. The pain is felt especially at the back of the eyes, perhaps with temporary blindness, and goes from front to back. It is often one sided (the left side more frequently than right). It is relieved by gentle movement, is worse in the afternoon, and though hard mental work aggravates, should the mind wander from one topic to another, the pain is eased. This corresponds to the most characteristic mental feature of Piper methysticum, relief of symptoms when attention is diverted to a new object.

Sleepiness belongs to the later stages and can be irresistible. Dreams are apt to be curious, nonsensical, occasionally amorous with seminal emissions, and on waking the patient is little refreshed.

All symptoms are relieved by turning the mind from one subject to another. There is an amelioration from change either in the emotional, mental or physical sphere. Thus change of position, open air and movement tend to relieve all symptoms.

Two symptoms of Piper methysticum have proved to be what are called ” keynotes”. There is an irresistible desire, when in pain, to change position, but unlike the modality of Rhus tox this movement only gives a little relief. This is perhaps like the restlessness of Arsenic and Aconite but while with these latter drugs the main impulse appears to be an emotional restlessness, with Piper (as with Rhus) the pain is the cause of the movement – it is a case of “seeking rest and finding none”.

The other modality is very well marked and is indeed the symptom that most often suggests the drug. It consists in the fact that all mental symptoms: excitement, depression as well as headache and other bodily pains are relieved by diversion of mind.

It appears as if any external stimulus aggravates but the replacement of one stimulus by another temporarily relieves.

This clearly marks the influence of Piper on the faculty of attention. Part of the analgesic effect of Opium appears to be due to its power of making the brain less attentive to sensory messages as well as its ability to lessen the intensity of these stimuli. As with Piper the relief is obtained mainly by diverting the attention. It is a familiar enough effect to us all that we can temporarily forget our troubles or minimize them if attention be strongly directed elsewhere.

The first inclination could be to consider that probably Piper patients are self-centred individuals making over-much of their feelings and not really enduring nearly as much as they think, so that diversion from themselves and their pains is not so very difficult. But this first conception is probably wrong. It is more likely that the effect of the drug is rather in making the faculty of attention more concentrated, as it were, so that when it is turned in a new direction it follows that to the exclusion of other stimuli.

Under hypnosis pain stimuli can be inhibited and it is well known that martyrs and fanatics in the grasp of their enthusiasm seem oblivious of physical reactions. The Piper effects seem to be more in line with the latter than the former, which are those of inhibition of a particular set of stimuli.

But while the fanatic is wholly possessed with his fanaticism, the patient who needs Piper can let a comparatively trivial diversion replace his reaction to pain and make him forget it almost as though the effect produced was that of so concentrating the attention that if one object is presented to it (not necessarily an obviously important one as with the religious fanatic), others cannot be perceived.

Eastern (and other) systems of ordering the body can train it to be relatively insensitive to pain. But this again is a different phenomenon, for with Piper methysticum there is not a general lowered apprehension of external stimuli but a concentration on one group alone. Probably this effect is responsible for the noteworthy feeling of increased mental power that goes with the drug for it is well known how easy it is to use the mind on the (alas! not too common) occasions when it feels free and active.

The effect of the drug is therefore less in producing profound changes in life rhythm than in using the ordinary rhythm more effectively perhaps speeding it up and giving a sense of more vitality.

But of course it can only do this valuable service in disease to those who are attuned to it and they will be the subjects whose minds show either generally or temporarily this tendency to concentrate on one thing at a time and a power to use it when in pain by substituting another group of stimuli, preferably a psychical one for the physical.

If we can think of this tendency as indicating a general power of speeding up life rhythms, which would naturally show first in the mental and emotional sphere but could hardly be confined to it, then the speeding up would help whatever mechanism we conceive as restoring the disease state to normal.

from The British Homœopathic Journal, May 1942