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Felter's Materia Medica on Veratrum Viride
VERATRUM VIRIDE
The dried rhizome and roots of Veratrum viride, Aiton (Nat. Ord. Liliaceae). An indigenous plant of swamps, low grounds, and moist meadows. Dose, 1 grain. Common Names: American Hellebore, Swamp Hellebore, Green Hellebore, Indian Poke. Principal Constituents.A powerfully toxic alkaloid veratrine (C32H49NO9), or cevadine, ocurring in both crystalline and amorphous forms; protoveratrine (C32H51NO11), also extremely poisonous; jervine, vertroidine, pseudojervine, rubijervine (sternutatory) and resin. Preparation.Specific Medicine Veratrum. Dose, 1/20 to 5 drops. Specific Indications.Pulse full, frequent, and bounding; pulse full, rapid, corded or wiry; pulse full, strong, and intense, with throbbing of the carotids; pulse rapid and beating so forcibly that sleep is prevented; tissues full, not shrunken, and surface flushed with blood; increased arterial tension, with bloodshot eyes; erysipelas resembling an ordinary inflammation; cerebral hyperaemia; sthenic fevers and inflammations; irritation of nerve centers due to an excited circulation; convulsions, with great vascular excitement, full pulse, and cerebral hyperaemia; puerperal eclampsia; red stripe down center of the tongue; weight in the epigastrium, with forcible circulatory pulsations. Action and Toxicology.Veratrum is a powerful circulatory depressant. The exact action of the individual alkaloidal constituents is yet undetermined, as well as the effect each produces in the sum total of the effects of the root. According to Wood, the drug is a spinal and arterial depressant having no direct action upon the spinal centers; the direct action of jervine upon the heart-muscle, and the stimulation of the inhibitory nerves by veratroidine lower the pulserate; the force of the heart-beat is lowered by the direct action of jervine upon the heart-muscle, while the same constituent, according to dose, produces a more or less complete vaso-motor paralysis. The depression of the spinal motor centers is attributed to jervine. The emetic action of veratrum is said to be due to the combined action of veratroidine and the resin. All vaso-motor depressants and all agents which diminish the vital force, favor the action of veratrum. Nausea is always the signal for suspension of the administration of the drug. Death from veratrum is caused by asphyxia. Veratrine and cevadine are identical. The veratrine of commerce, however, is variable in composition, but its action is probably mostly due to the amount of true cevadine present. Late investigations show that most of the action of veratrine is that of cevadine, though veratrum does not furnish the veratrine of commerce (see Veratrina). One of the peculiar effects of veratrine is that of muscular contracture produced when in contact with the heart and the voluntary muscles. It is exhibited in a prolongation of relaxation following the contraction of the muscle, appearing almost like a tetanic effect, but it is free from any rigidity or spasmodic qualityin reality a prolonged contraction in which there is a long and gradual relaxation several times longer in duration than that occurring in the unpoisoned muscle. American hellebore exerts an influence upon the system quite similar to that of White Hellebore (Veratrum album). Veratrine does not represent the action of this plant, which contains but a small proportion of this body. Applied to the skin, veratrum is rubefacient; and to the nose, excites sneezing. Small doses of veratrum appear at first not to affect the frequency of the pulse, but to lower its force; it afterwards slows the pulse, it becoming moderately full and soft, and remaining so, unless the patient, during this stage of depression, attempts to rise or make any exertion, when the pulse becomes very rapid, small, thready, and sometimes almost imperceptible. During the stage of depression there is marked muscular weakness and relaxation, and nausea and vomiting take place, the contents of the stomach being evacuated first, and then those of the gall-bladder. Occasionally a watery diarrhea is caused by veratrum, sometimes amounting to hypercatharsis, but as a rule purging is not produced. The nausea produced by veratrum is intense, and the vomiting severe and often persistent, making it, therefore, an unsafe emetic. The most characteristic action of veratrum is its effects upon the movements of the heart and upon vascular tonus. The pulse-rate has been lowered to thirty-five beats -a minute with this agent, a corresponding depression of force accompanying this action. When such depression is reached, it is seldom that emesis can. be prevented. In large doses it is a very dangerous agent, yet, singularly, fatalities from its use are rare. Toxic doses produce an exceedingly weak heart-action, almost indistinguishable, running pulse, reduced temperature, cold, clammy sweat, extreme retching and incessant vomiting, dizziness, faintness, failure of sight, pupillary dilatation, complete muscular prostration, slow, shallow breathing, sleepiness, coma, and unconsciousness, with sometimes stertorous breathing. The prompt emesis induced by this agent undoubtedly prevents lethal effects. In poisoning by veratrum, withdrawal of the drug and free stimulation will quickly overcome the depression. Large draughts of warm water may be given to encourage and assist emesis until the stomach has been thoroughly washed out. This should be followed by undiluted whiskey or brandy to check the vomiting. Opium or morphine may be given by mouth or otherwise, ammonia and alcoholics may be used by enema or hypodermatically, and strychnine or digitalis may be given by the latter method. External heat, sinapisms, friction, etc., must be utilized, and under no circumstances must the patient be allowed to rise from the recumbent position, not even to raise the head to vomit. Therapy.External. Painted upon boils, felons, carbuncles, abscesses, inflamed acne, cellulitis, and other local inflammations, veratrum wi1
The dried rhizome and roots of Veratrum viride, Aiton (Nat. Ord. Liliaceae). An indigenous plant of swamps, low grounds, and moist meadows. Dose, 1 grain. Common Names: American Hellebore, Swamp Hellebore, Green Hellebore, Indian Poke. Principal Constituents.A powerfully toxic alkaloid veratrine (C32H49NO9), or cevadine, ocurring in both crystalline and amorphous forms; protoveratrine (C32H51NO11), also extremely poisonous; jervine, vertroidine, pseudojervine, rubijervine (sternutatory) and resin. Preparation.Specific Medicine Veratrum. Dose, 1/20 to 5 drops. Specific Indications.Pulse full, frequent, and bounding; pulse full, rapid, corded or wiry; pulse full, strong, and intense, with throbbing of the carotids; pulse rapid and beating so forcibly that sleep is prevented; tissues full, not shrunken, and surface flushed with blood; increased arterial tension, with bloodshot eyes; erysipelas resembling an ordinary inflammation; cerebral hyperaemia; sthenic fevers and inflammations; irritation of nerve centers due to an excited circulation; convulsions, with great vascular excitement, full pulse, and cerebral hyperaemia; puerperal eclampsia; red stripe down center of the tongue; weight in the epigastrium, with forcible circulatory pulsations. Action and Toxicology.Veratrum is a powerful circulatory depressant. The exact action of the individual alkaloidal constituents is yet undetermined, as well as the effect each produces in the sum total of the effects of the root. According to Wood, the drug is a spinal and arterial depressant having no direct action upon the spinal centers; the direct action of jervine upon the heart-muscle, and the stimulation of the inhibitory nerves by veratroidine lower the pulserate; the force of the heart-beat is lowered by the direct action of jervine upon the heart-muscle, while the same constituent, according to dose, produces a more or less complete vaso-motor paralysis. The depression of the spinal motor centers is attributed to jervine. The emetic action of veratrum is said to be due to the combined action of veratroidine and the resin. All vaso-motor depressants and all agents which diminish the vital force, favor the action of veratrum. Nausea is always the signal for suspension of the administration of the drug. Death from veratrum is caused by asphyxia. Veratrine and cevadine are identical. The veratrine of commerce, however, is variable in composition, but its action is probably mostly due to the amount of true cevadine present. Late investigations show that most of the action of veratrine is that of cevadine, though veratrum does not furnish the veratrine of commerce (see Veratrina). One of the peculiar effects of veratrine is that of muscular contracture produced when in contact with the heart and the voluntary muscles. It is exhibited in a prolongation of relaxation following the contraction of the muscle, appearing almost like a tetanic effect, but it is free from any rigidity or spasmodic qualityin reality a prolonged contraction in which there is a long and gradual relaxation several times longer in duration than that occurring in the unpoisoned muscle. American hellebore exerts an influence upon the system quite similar to that of White Hellebore (Veratrum album). Veratrine does not represent the action of this plant, which contains but a small proportion of this body. Applied to the skin, veratrum is rubefacient; and to the nose, excites sneezing. Small doses of veratrum appear at first not to affect the frequency of the pulse, but to lower its force; it afterwards slows the pulse, it becoming moderately full and soft, and remaining so, unless the patient, during this stage of depression, attempts to rise or make any exertion, when the pulse becomes very rapid, small, thready, and sometimes almost imperceptible. During the stage of depression there is marked muscular weakness and relaxation, and nausea and vomiting take place, the contents of the stomach being evacuated first, and then those of the gall-bladder. Occasionally a watery diarrhea is caused by veratrum, sometimes amounting to hypercatharsis, but as a rule purging is not produced. The nausea produced by veratrum is intense, and the vomiting severe and often persistent, making it, therefore, an unsafe emetic. The most characteristic action of veratrum is its effects upon the movements of the heart and upon vascular tonus. The pulse-rate has been lowered to thirty-five beats -a minute with this agent, a corresponding depression of force accompanying this action. When such depression is reached, it is seldom that emesis can. be prevented. In large doses it is a very dangerous agent, yet, singularly, fatalities from its use are rare. Toxic doses produce an exceedingly weak heart-action, almost indistinguishable, running pulse, reduced temperature, cold, clammy sweat, extreme retching and incessant vomiting, dizziness, faintness, failure of sight, pupillary dilatation, complete muscular prostration, slow, shallow breathing, sleepiness, coma, and unconsciousness, with sometimes stertorous breathing. The prompt emesis induced by this agent undoubtedly prevents lethal effects. In poisoning by veratrum, withdrawal of the drug and free stimulation will quickly overcome the depression. Large draughts of warm water may be given to encourage and assist emesis until the stomach has been thoroughly washed out. This should be followed by undiluted whiskey or brandy to check the vomiting. Opium or morphine may be given by mouth or otherwise, ammonia and alcoholics may be used by enema or hypodermatically, and strychnine or digitalis may be given by the latter method. External heat, sinapisms, friction, etc., must be utilized, and under no circumstances must the patient be allowed to rise from the recumbent position, not even to raise the head to vomit. Therapy.External. Painted upon boils, felons, carbuncles, abscesses, inflamed acne, cellulitis, and other local inflammations, veratrum wi1
VERATRUM ALBUM
The rhizome and roots of Veratrum album, Linné (Nat. Ord. Liliaceae). Europe, especially in the Alpine and Pyrenean districts. Common Names: White Hellebore, White Veratrum. Principal Constituents.Protoveratrine (C32H51NO11), intensely poisonous; protoveratridine, jervine (the most abundant principle), pseudo-jervine, and rubijervine. No cevadine (veratrine) is present. Preparation.Homeopathic Mother Tincture of Veratrum Album. Dose, fractional (see below). Specific Indications.Gushing, watery diarrhea, with spasmodic or cramp-like action of the intestines and belly-walls; cold face, sunken eyes, and body covered with a cold sweat. Action and Therapy.Though closely resembling Veratrum viride in effects, this agent is used for entirely different purposes, based upon Homeopathic usage. These are choleraic diarrhea, cholera morbus, cholera infantum, and Asiatic cholera, to control the gushing discharges and check vomiting. The Homeopathic mother tincture in 3x dilution in the proportion of thirty drops in four ounces of water is the usual form of administration, the dose being a teaspoonful of this mixture every fifteen to thirty minutes. It is not often used in this country.1
The rhizome and roots of Veratrum album, Linné (Nat. Ord. Liliaceae). Europe, especially in the Alpine and Pyrenean districts. Common Names: White Hellebore, White Veratrum. Principal Constituents.Protoveratrine (C32H51NO11), intensely poisonous; protoveratridine, jervine (the most abundant principle), pseudo-jervine, and rubijervine. No cevadine (veratrine) is present. Preparation.Homeopathic Mother Tincture of Veratrum Album. Dose, fractional (see below). Specific Indications.Gushing, watery diarrhea, with spasmodic or cramp-like action of the intestines and belly-walls; cold face, sunken eyes, and body covered with a cold sweat. Action and Therapy.Though closely resembling Veratrum viride in effects, this agent is used for entirely different purposes, based upon Homeopathic usage. These are choleraic diarrhea, cholera morbus, cholera infantum, and Asiatic cholera, to control the gushing discharges and check vomiting. The Homeopathic mother tincture in 3x dilution in the proportion of thirty drops in four ounces of water is the usual form of administration, the dose being a teaspoonful of this mixture every fifteen to thirty minutes. It is not often used in this country.1
References
1) Felter, Harvey Wickes, 1922, The Eclectic Materia Medica, Pharmacology and Therapeutics, Cincinnati, Ohio.