PHYSOSTIGMA: The Discarded Vine

By Krista Heron, ND, DHANP

[Note: This lovely woman continues to respond to Physostigma, some 16 years since her initial prescription. Her MS has progressed very little over these years and her bladder symptoms in particular are helped greatly by this remedy.]

I have been quite curious for some time about the remedies made from vines, wondering if their winding and climbing tendency would say much about the nature of the remedies made from them. I have been charmed at how the beans and peas that grow in my garden wander and seek support from other plants or structures; playfully wrapping their tendrils around anything they can reach. They have flowers with mandible like structures that seem to talk, receiving visitations from bees who seem unaware that they look as if they could be swallowed at any moment. These vines are members of the legume (Fabaceae or Papilionaceae) family and include such familiar remedies as Baptisia, Lathyrus and Melilotus.

The remedies in this family present with many problems of fatigue, motility and paralysis. According to Jan Scholten, this may be due to the possible poisoning by the amino acid glutamate that then affects the neuro transmitter serotonin. We also see many symptoms of delusion. Those who need these remedies often feel that they have done something wrong. For example, Baptisia feels that they cannot succeed, that they do everything wrong; Melilotus feels they are pursued by their enemies or the police and that they are about to be arrested; and Robinia feels they have been disgraced.

Physostigma, a member of this family, is a perennial woody climber found in tropical West Africa. Its leaves are large and pinnate with purple butterfly-like flowers. The fruit is a reddish brown bean with two or three white oval seeds. These beans ripen year round but are most abundant during Africa's rainy season. These beans contain alkaloids that are poisonous.

Historically, the beans were used to determine the guilt of those accused of witchcraft. If the accused vomited within a half hour they were considered innocent, but if they died from the poison they were found guilty. In the same way that the patients who respond to the other legume remedies feel they have done some wrong, those who respond to Physostigma feel they are castaways. It is easy to imagine how someone accused of a crime and then ostracized by their community could have this feeling.

The alkaloids within Physostigma stimulate the parasympathetic nerves and medically have been used as an antidote to atropine. They cause contraction of the pupil and ciliary muscles and have a profound effect on the striated muscles as a whole. The limbs seem weary and unresponsive. There is fatigue and weakness. The case I will present shows a wonderful response to this remedy in a patient with multiple sclerosis. It is from her that I first began to understand Physostigma and other members of this family.

Diane first came to see me in February of 1998. She was a beautiful, elegant sixty-year-old from Georgia who had moved to the Pacific Northwest a few years before. She wanted some relief from her worsening multiple sclerosis. I found her first words interesting:

"Generally you start at the beginning, but I'd like to start at the end."

This was curious to me at the time, and now seems quite illustrative of how a climbing vine might begin to tell its tale.

"I've had more symptoms these last four years, but I was diagnosed twenty years ago. Now walking is difficult for me because of my balance. Sometimes I have problems with my vision and I have a macular hole in my left eye. Recently I have less feeling and dexterity in my hands and I have a neurogenic bladder. It doesn't empty well. My initial symptom was numbness in the left arm and then eventually numbness in both legs, this was in my twenties around the birth of my children."

"I am essentially married though I haven't lived with my husband for two years. Our separation was amicable and my life is better alone. Both my parents are dead. I grew up in Georgia and lived there until I was forty. My parents were seemingly successful although my mother was an alcoholic. We were raised by servants. My sister was six years older and she saw my parents as cold and lacking in love. I just thought they didn't want to be with me. That there was something wrong with me."

Here we can see the often observed legume delusion that there is something wrong with her and particularly Physostigma's feeling of being discarded or thrown away. You see this sentiment in Diane's description of her parents and how she experienced their attitude toward children. Because she was placed in the hands and care of servants rather than her parents she felt unwanted.

Diane continues: "My father was disapproving and controlling. The only way to survive was to play the game. He was a very wealthy man, very charming and dictatorial; someone I couldn't trust. He would say one thing and then do another. He would give you something and then take it away. There was no way out.... You couldn't ask directly, you would try to make him think it was his idea. So I couldn't ask for what I wanted nor could I go against his authority."

This idea that there is no way out is interesting in light of her feeling of being cast away. Here she feels trapped. The climbing vine seeking someplace to go and the only solution is to twist and turn so that the obstacle she is trying to maneuver around can be overcome. But she cannot move, she cannot exert her will and successfully ask and receive what she needs. This seems metaphorical to this disease of multiple sclerosis. And analogous to Physostigma, who has the feeling that their muscles do not respond to the will.

"My mother was just there, but not there. She didn't want to talk to you. Mother was an alcoholic by the time I was eleven. I couldn't count on her.

“I ran away from home and was married for sixteen years. I was nineteen when I had my first child and twenty-one and twenty-five for the other two. My husband was very gregarious and an alcoholic. I supported him and our three children those last years of our marriage.

“My second marriage lasted five years. Six months after the divorce I met my third husband. He spent all his time working and fixing. He'd bring coffee to you but he would never sit down. He wanted to work, I wanted to rest. After a year I decided to move to Seattle, [now] I have a lot of support...."

She is like the climbing vine seeking the strong support of something. Yet it doesn't support her. She finds herself in marriages where she is the primary provider, the one who maintains and sustains the relationship. We also see the theme of overwork and rest. All the plants in the Fabaceae family have the ability to fix nitrogen in the soil. The function of nitrogen is to increase growth of the leafy parts of the plant. These legumes essentially provide their own fertilizer. They are plants who do everything: grow and create fruits and flowers as well as build and replenish the soil they live in. Diane has overworked too. She has longed for support but has supported her husbands instead. And now she longs to rest, to enjoy a simple life.

"I now find [myself] keeping a lovely home. I fill it with flowers and then sit in a chair and read."

She fills her house with flowers and sits down to enjoy them. Scholten speaks of this trait. He says the remedies in the Fabaceae family long to enjoy life, a life without trouble or complication; one that is beautiful, clean and surrounded by the beauty of nature. And that this characteristic comes from the nitrogen element in the plant.

"My life before the diagnosis was very free. I learned a lot. I was with my second husband and we had no jobs, no money, really didn't know where the next dime was coming from."

This is the time when her first symptoms were expressed, a time when she felt unsure of the kind of support she could count on.

"The first symptoms were in my eyes. It came after an abortion, after the anesthesia. I couldn't focus my eyes and my peripheral vision was less. At first I didn't pay attention to it. Later I thought, "This is like I don't want to open my eyes, I don't want to look out. It was worse if I stood up and looked, I'd almost lose my balance."

"When I was little I was afraid to go to bed so I would leave the door open. I had all these colors in my eyes and I thought they were coming after me. I had nightmares for twenty years until [I was] forty. I saw a dark figure in a corner who I thought was trying to get me. I was terrorized. I'd wake my family up by screaming. Sometimes I'd get up and run."

It is interesting that Physostigma has many symptoms centered in the vision and eyes. Even at a young age we see Diane experiencing visual distortions and how she interprets them as menacing. The colors were after her and later this symptom evolves to become a dark figure. We see these symptoms in the repertory as "Vision; colors before the eyes" and "Delusions; sees spectres, ghosts and spirits". Later Diane experiences a blurring of her vision. Again we see this in the materia medica: "Vision as if there was a film over the eye." Her nightmares of a menacing figure occur during the time when her physical symptoms are in remission.

"My first symptoms came near my pregnancies in my twenties. I felt caught; I didn't want to be pregnant. But then the symptoms went away. Why did my symptoms come back at forty? It was the first time I was really free. But I couldn't find my place. Suddenly I had all this freedom at forty and what do I do but get MS. I thought, [now] I have an excuse to say ‘No’... it's rude [otherwise]. I just want to please people at the sacrifice of myself, I come last. I would bend over backwards to be nice. Otherwise you would be shunned. No one would want to be with you and I want people to be with me."

Diane feels caught again and can't directly create the life she desires. When she finally comes to a time in her life when she can create freedom and choose, she feels that she cannot find her place; she is waving in the wind like a loose tendril. She can't find it in herself to say "No." Instead she finds it easier to bend over backward to find her support and to avoid being shunned or cast away. Scholten has said that the legume family has a desire for help but that they feel that no one can, or will, help them.

Diane had a variety of confirmatory symptoms as well. Her numbness began in her left arm, as does Physostigma. She also disliked drinking cold water and had a history of constipation. I gave her Physostigma 200 on February 23, 1998.

She came back April 14 and reported, "I saw a great change even the first day. I felt more energetic and everything seemed much easier. I didn't want to sit down. I have better bladder control and my attitude is better. I have more energy to do things and better mental acuity. I feel happy."

On May 27 she stated "There is an overall wellness. I forget I can't walk as well as I think I can. My vision is pretty good, as is my balance. I have a little less dexterity in my left hand. I used to not be able to go anywhere because of the bladder problem. Now it is no problem."

September 2 she was having more trouble so I gave her Physostigma 1M. When she returned to the office on October 6 she reported "The remedy helped. I notice my bladder symptoms and energy are much improved."

March 9, 1999, she started to lag so I repeated Physostigma 1M again. She had had some dental work with Novocaine and it had fatigued her greatly. On June 1 she stated, "My bladder control is doing great and my immune system is much improved. I haven't had any herpes outbreaks and my energy is better. My spirits have been very good. My daughter had surgery so I had to travel to Boston to help her. It was a boost to know I could get along by myself. It is amazing to get past this fear."

October 25 I spoke with Diane again: "I feel so much better since I first came to see you. I was about to have a catheter inserted because my bladder problems had become so severe. But since taking this remedy the quality of my life has vastly improved. To have bladder control is wonderful!” Diane reports that she has not lost any dexterity or feeling in her limbs over the course of her treatment.

“I feel in a very good space now, more at ease and joyous about life. I am better at asking for what I want. I don't always get it but that is true for everybody. If I just let go, everything works out. Whatever is going to be, will be. I am less surprised when people want to be with me now. I am able to take that truth in and know I am a pleasure to be with. I feel more compassion for myself and others now and I live in that space of peace more and more."

Further follow  up to the case

December 21, 1999

I am having difficulty walking and my vision is not very good. It is harder to read and everything is blurred. Words fade in and out on the page. I have a macular hole.

P: Physostigma LM1

February 1, 2000

I’ve been doing amazingly well. I have very good energy, I have been swimming  again and my bladder symptoms are better. I haven’t had any herpes eruptions and my sleep has improved.

P: continue with remedy

October 18, 2004

I still hear from or see this patient on occasion. She continues taking the remedy, as needed, as an LM potency. Her mobility has maintained, as has her urinary function. She lives a full life.

Because multiple sclerosis is a progressively deteriorating disease, I am pleased with the progress to date with Diane. I feel we have brought some health back, though we still see some progression of the disease. I feel hopeful of further progress because of the healing she has done in the emotional sphere.

I believe that the main ways that Diane healed directly correspond with the center of this remedy. For me the essential emotional symptoms of Physostigma include the feeling of being cast away, the longing for support yet feeling undeserving and the tendency to overwork all the while longing for rest and simple beauty.

Diane felt cast aside by her parents and surprised when people would want to spend time with her. Now she knows people enjoy her and she embraces that truth. She used to feel undeserving of the help of others. Now she feels more able to ask for what she wants. She understands that at times she may receive this and other times not. But now when others choose not to help, she knows it is not about her or some wrong she has done. She believed in the past that she needed to overwork to get what she wanted. Now she accepts what the universe or her life provides.

Physostigma’s main expression on the physical level is seen in vision changes, palpitations, constipation and muscular numbness, weakness and paralysis, especially of the left arm. This weakness is common to the legume family as a whole. Lathyrus, Indigo, Baptisia and others all experience muscular weakness. The limitations of motility that are seen in this family of remedies are compelling because these plants survive by climbing. They need to move and wind their way to more light and greater space. These plants also have a need for support, as do the people who need these remedies. They long for someone to depend on yet feel so undeserving. They are hopeless of ever receiving help, often because they feel they have done some wrong. And because they feel undeserving they must overfunction or work harder to secure the support they need. In the plant we see this in their ability to provide their own fertilizer. In the patient we see this over functioning juxtaposed to their longing for a simple life, a life that will restore their sense of beauty and nurturance.

Published in American Homeopath, 2000