Podophyllum: a nearly routine medicine for traveller's diarrhea

Townsend Letter for Doctors and Patients,  July, 2004  by Robert Ullman,  Judyth Reichenberg-Ullman

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Those of you familiar with our column may catch your jaws dropping at the mere mention of the phrase "routine medicine," given our tendency to regularly harp on the notion that there are two-thousand-plus homeopathic medicines and more being proven every day. If you bristle at needing to study homeopathy for years before feeling confident in your prescribing, you will find this article a refreshing change of pace. After we get you hooked on how brilliantly Podophyllum works for acute diarrhea, you may indeed want to sink your teeth into constitutional prescribing. After all, if you can cure many parasitic illnesses so simply with homeopathy, why not venture into the territory of longstanding allergies, chronic fatigue, and depression? But that, of course, is another matter covered in other columns.

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The Particulars of Podophyllum

Podophyllum peltatum (May apple or Duck's foot) is a foot-high member of the Berberidaceae family, indigenous to the US, and was first proved homeopathically in 1846. So, it is a mainstay of homeopathic prescribing. Judyth first remembers hearing about this medicine, not in her homeopathy classes at Bastyr, but rather in a small study group shortly after graduation. A classic case of traveller's diarrhea was presented, much like the cases in this article. The Podophyllum prescription was clear to everyone but her. An obvious gap in her homeopathic training, she resolved to become more familiar with acute medicines, rather than just the 40 or so "polychrest" medicines presented at Bastyr. Perhaps this very experience was what led us to write Homeopathic Self-Care: The Quick and Easy Guide for the Whole Family. There are many wonderful homeopathic medicines, like Podophyllum, which are a godsend for acute suffering, and whose main features, or keynotes, are easily learned.

This medicine has a primary affinity for the rectum, liver, and intestines and, though it can also be of benefit for throat, ovarian, and scapular problems, it is for acute GI distress that we have found it to be invaluable over and over. We consider it to be among our top five don't-leave-home-without-it medicines, especially when visiting the backcountry or Third World countries, where the water systems are not so sanitized.

We don't recommend that you peruse this particular column while enjoying a delectable lunch, for it may ruin your appetite. If you remember nothing else about Podophyllum, think of relentless, watery diarrhea. In the homeopathic repertories, the word used most often to describe the explosive nature of the bowel movements is "forcible." It is also interesting that it is mentioned in the literature under a "sinking sensation after stool" because this is just the way we have felt, in India or other faraway lands, upon going to the bathroom and finding ourselves in such a state. It's that, "Oh, shit" kind of feeling (excuse the pun). The one that makes you start thinking about what you have planned for the next day or two; where and what you will be eating; and how close you will be eating; and how close you may be to a decent bathroom, toilet paper, etc. Though these are not significant considerations in North America, Europe, and Down Under, they are of prime importance in many less-developed countries, as well as when we are off enjoying the seclusion of Mother Nature.

Although the symptoms of Montezuma's Revenge or Delhi Belly can arise anytime, it is not uncommon to awaken from a sound sleep, rushing to the bathroom around four a.m. The suddenness of this state is memorable, as are the abdominal cramping and resulting exhaustion. Another common feature of those needing Podophyllum is the gurgling and rumbling sound of the gas in the abdomen. The diarrhea is watery and profuse and may be foulsmelling. The consistency of the stool may be pasty and the color yellowish, which is not surprising for a liver medicine. We have most often found the stools to be brown or brownish-yellow. Although the diarrhea, according to the literature, can be painless, cramping is frequent.

A Few Podophyllum Cases

Rob: A seasoned world traveler and patient of ours for over 10 years, Rob was very excited about his off-the-beaten-track overland trip through the Himalayas. Already an Indiophile, he had been invited by a merchant friend to visit mountain villages little known to Westerners. Rob's two main concerns were acute diarrhea and altitude sickness. We stocked his natural medicine chest with Podophyllum, Coca (for altitude distress), and our favorite Echinacea-Goldenseal formula to use at the first sign of a sore throat or flu. Rob did, as feared, contract a vengeful case of the runs while in Nepal, and Podophyllum came quickly to the rescue. We might add that he found the Coca to be invaluable for the altitude.

Samantha: Jenny and Paul were a bit hesitant to take their four-monthold pride and joy on their vacation to Puerto Vallarta. They had read about the severe danger, and even fatalities, resulting from acute diarrhea and dehydration in babies. They took along our Homeopathic Self-Care book and kit just in case. It was a good thing that they did because within days of their arrival Sami, who was still breastfeeding, did come down with a case of copious liquid stool, along with loud rumbling and growling of her abdomen. Jenny, too, developed an explosive, frequent, watery stool, which left her feeling wiped out. Both mother and daughter took Podophyllum promptly with complete success.