Apocynum cannabinum

Derived from the fresh root of Apocynum cannabinum, a perennial herb native to North America. Belonging to the Apocynaceae family, the plant contains powerful cardiac glycosides similar to digitalis, making it toxic in crude form. In homeopathic dilution, its sphere of action centres on the heart, kidneys, and serous membranes, with marked influence over water balance and oedematous states.

Proved by Dr. W. Williamson and others in the 19th century, with extensive toxicological observations from herbal overdoses. Clinical experience from Dr. Hale and Dr. Burt greatly enriched its symptom picture.

A remedy of failing vitality and fluid retention, Apocynum cannabinum speaks to the exhausted heart and kidneys, where the system is water-logged yet the natural outlets are closed. It covers the picture of passive dropsy—pale, bloated, breathless, cold—where the body is drowning in its own retained fluids.

• Heart and circulation – depresses the myocardium, slows but weakens the pulse [Hale].
• Kidneys – markedly affects renal secretion; produces scanty urine in dropsy.
• Serous membranes – hydrothorax, hydropericardium, ascites.
• Gastro-intestinal tract – nausea, vomiting, prostration.
• Skin – coldness, pallor, and clammy sweat in collapse.

Mental dulness, with slow comprehension, is typical in profound dropsical states. There is a peculiar indifference to surroundings, mingled with mild anxiety when breathing is laboured. The mind seems weighted by physical suffering, and the patient often answers reluctantly, conserving energy [Hering].

Restless from dyspnoea; frequent waking to change position.

Profound prostration; rapid sinking of strength in cardiac and renal failure. Characteristic is the coexistence of scanty urine with general dropsy—a keynote guiding to its use [Clarke].

Low-grade fever may accompany acute dropsy.

Tendency to chilliness; sweat profuse but cold.

Fullness and heaviness of the head accompany cardiac and renal failure. In some cases, a sensation as if the head were being pressed from within outwards occurs during acute hydrocephalus in children. Vertigo is common when rising, due to low cardiac output.

Eyes dull, surrounded by dark rings in chronic dropsy. Eyelids oedematous, sometimes so swollen as to nearly close the eyes. Vision blurred from anaemia and fluid retention.

Occasional roaring or rushing noises in ears, especially when the pulse is feeble. In extreme weakness, hearing may seem dulled.

Nostrils dry and pale, or cold and pinched in collapse.

Face pale, bloated, waxy, or of a sallow, earthy hue in chronic heart disease. Expression dull and heavy. Lips may be bluish in hydrothorax.

Dryness of mouth without thirst in many cases, though intense thirst may be present in febrile dropsy. Tongue pale, swollen, sometimes indented by the teeth.

Dryness and difficulty swallowing in cases with ascites and general debility.

Oppression of the chest, with shortness of breath even at rest, markedly worse on lying down. Hydrothorax with necessity to sit upright; any exertion causes gasping. Pulse slow but feeble, with tendency to irregularity.

Marked cardiac depression—pulse weak, slow, soft, sometimes irregular. Hydropericardium with great dyspnoea. Palpitation from least exertion.

Dyspnoea constant, aggravated by motion or recumbency. Breathing shallow; patient seeks cool air yet chills easily.

Nausea persistent, often with repeated vomiting of watery fluid or food soon after eating. Vomiting may relieve abdominal fullness temporarily [Hale]. Stomach feels distended and heavy. Appetite greatly diminished.

Great distension from ascites; walls tense and shiny. The patient complains of a sense of weight and pressure, worse when lying flat.

No special proving symptoms, but constipation is common in advanced dropsy due to inactivity.

Scanty urine is the keynote—sometimes almost suppressed. When passed, urine is high-coloured, hot, and may contain albumen [Hering].

Loss of appetite; occasional thirst for cold drinks.

Occasional amenorrhoea associated with dropsical states.

Aching in lumbar region, especially in renal dropsy.

Ankles and feet swollen, oedematous, leaving pits on pressure. Legs heavy, tired, and cold.

Cold, clammy sweat in collapse; pale and waxy in chronic disease. Oedematous infiltration of subcutaneous tissues.

• Digitalis – Similar heart and kidney action; Apocynum more specific when dropsy coexists with scanty urine.
• Arsenicum album – Restlessness, anxiety, and burning pains more marked; Apocynum less restless, more passive prostration.
• Helleborus niger – Dropsy with suppression of urine, but more cerebral symptoms.

• Complementary: Digitalis, Arsenicum album.
• Antidotes: Camphora (in toxic doses).
• Inimical: None recorded.

Valuable in ascites, hydrothorax, hydropericardium, and anasarca from heart or kidney disease. In pregnancy, may relieve some forms of cardiac dropsy. Best given in low to medium potencies, repeated cautiously to avoid aggravation.

Mind

• Indifference to surroundings.
• Dullness of mind in illness.
• Slowness in answering.
• Anxiety with breathlessness.
• Weak memory from prostration.

Head

• Heaviness in dropsy.
• Vertigo on rising.
• Fulness in hydrocephalus.
• Pale face with head symptoms.
• Headache from cardiac weakness.

Eyes

• Oedema of lids.
• Dark circles around eyes.
• Blurred vision with dropsy.
• Pale conjunctiva.
• Sunken eyes in collapse.

Stomach

• Nausea with dropsy.
• Vomiting of watery fluid.
• Distension after eating.
• Aversion to food.
• Heaviness in stomach.

Skin

• Cold, clammy sweat.
• Waxy pallor.
• Oedema of skin.
• Pitting on pressure.
• Pallor with collapse.

Extremities

• Swelling of ankles.
• Pitting oedema.
• Cold feet in dropsy.
• Weakness in legs.
• Heaviness of limbs.

Generalities

• Dropsy with scanty urine.
• Weak pulse.
• Aggravation from motion.
• Better sitting up.
• Prostration extreme.

Hale, E. M. – Detailed cardiac and renal sphere; keynote of scanty urine with dropsy.
Hering, C. – Mental dulness, indifference, and extreme prostration noted in advanced dropsy.
Clarke, J. H. – Emphasis on serous effusions and hydrothorax, with modalities.
Burt, W. H. – Toxicological symptoms, especially vomiting and cardiac depression.