Echinacea

CHIONANTHUS
   The bark of the root of Chionanthus virginicus, Linné. (Nat. Ord. Oleaceae.) United States from Pennsylvania southward. Dose, 5 to 30 grains. Common Names: Fringe Tree, Old Man's Beard, Snowdrop Tree. Principal Constituents.—Chionanthin and saponin. Preparation.—Specific Medicine Chionanthus. Dose, 5 to 30 drops. Specific Indications.—Icteric hue of skin and conjunctiva; dull hepatic pains and tenderness or soreness upon deep-pressure; light claycolored, or frothy yeast-like stools; sallow, dirty-looking skin with hepatic tenderness and expressionless eyes; intense cutting pain from liver to navel, attended by nausea, vomiting, and great prostration; icteric coloration without pain; the urine stains the clothing yellow; colic, with green stools; jaundice, with pale watery alvine discharges and intense itching of the skin; pain simulating colic, extending from liver region over the whole abdomen; tympanites; and presence of sugar in the urine. Action and Therapy.—Medicines that actually and positively influence the liver and its secretions are not numerous, notwithstanding that for many years much misdirected attention was bestowed upon that greatly abused and usually very innocent organ. “Liver-tapping” virtues, now quite forgotten, were ascribed to mercurials and many other powerful drugs. Those that have weathered the campaign and been found to have a lasting reputation have been vegetable drugs chiefly and of either domestic origin or of Eclectic development. None more deserves a place among these than chionanthus. There are two prime indications for chionanthus—jaundice as shown by the icteric hue of the skin and conjunctiva, and hepatic colic with soreness in the region of the liver. The pain is dull, heavy, and in the right hypochondrium, with a sense of weight and fullness, there is soreness even on light pressure and deep-seated tenderness on strong pressure, the feces are light in color and float upon water, the urine scanty and orange-tinted, there are occasional hectic flushes, and sometimes diarrhea, with frothy, yeast-like stools. Chionanthus is the most positive remedy for simple jaundice not dependent upon malignant or other organic changes in the liver and its appendages. It relieves portal congestion promptly, and is therefore a logical remedy for hepatic engorgement. Whether it is a remedy for jaundice associated with gall-stones, or dependent thereon, has been a question of dispute. Practically it seems to act in any instance where the imprisoned bile can be liberated by reducing the attendant swelling and congestion. In complete obstruction it fails, as do other remedies. One effect of chionanthus is to attenuate the bile, and there can be little doubt that it prevents the formation of biliary calculi. When the concretions are small and pass with a fair degree of ease, we believe it beneficial; but when they are strongly impacted it is doubtful whether chionanthus has any influence upon them or power to dislodge them. But in jaundice depending upon functional inactivity and other forms of mechanical obstruction, it is the first- remedy to be considered. In a single case of Weil’s disease that came under our care, it was a most efficient remedy, echinacea being alternated with it to control septic manifestations. For the acute catarrhal jaundice of children and the jaundice of the new born, it acts more favorably than any remedy known to us. When gastric and duodenal troubles depend upon deficient action of the liver, chionanthus is most frequently indicated. It is useful then in chronic intestinal inflammation, in chronic duodenitis, chronic gastritis, the irritation of stomach and bowels due to high living, and is a remedy of considerable value in the gastro-intestinal and hepatic disorders of dipsomania. It has been asserted by many whose large experience entitles them to credence that chionanthus is a potent and satisfactory medicinal aid in glycosuria, when the glycogenic function of the liver is at fault. While it is believed to have some effect upon the functions of the pancreas, it is probably of little value in that worst form of diabetes mellitus in which the cells of Langerhans are destroyed. It should be given renewed study in the glycosuria of obesity and when sugar intolerance alone, and not starch disturbances, create what so often passes for diabetes. These are rather prediabetic conditions, if tending in that direction at all, but even if untreated might never reach the true diabetic state. There is good reason to believe that the prolonged use of chionanthus will be of much benefit in such cases.¹

ECHINACEA
   The dried root of Brauneria angustifolia, Linné (Echinacea angustifolia [DeCandolle], Heller). (Nat. Ord. Compositae.) In rich prairie soils of western United States, from Illinois westward through Nebraska and southward through Missouri to Texas. Common Names: Narrow-leaved Purple Coneflower, Purple Coneflower, Coneflower. Principal Constituents.—Minute traces of an unimportant alkaloid and an acrid body (1/2 to 1 per cent), probably of a resinous character linked with an organic acid. The latter is the chief active principle of the drug. Preparations.—1. Specific Medicine Echinacea. Dose, 1 to 60 drops, the smaller doses being preferred. Usual method of administration: Rx. Specific Medicine Echinacea, 1-2 fluidrachms; Water, enough for 4 fluidounces. Mix. Sig.: One teaspoonful every 1 to 3 hours. 2. Echafolta. (A preparation of Echinacea freed from extractive and most of the coloring matter. It also contains a small added quantity of tincture of iodine. The label states that is iodized). Dose, 1 to 60 drops. Usually administered the same as the specific medicine; except when iodine is contraindicated, or is undesired. 3. Echafolta Cream. An ointment for external use. Specific Indications.—”Bad blood”; to correct fluid depravation, with tendency to sepsis and malignancy, best shown in its power in gangrene, carbuncles, boils, sloughing and phagedenic ulcerations, and the various forms of septicemia; tendency to formation of multiple cellular abscesses of a semi-active character and with pronounced asthenia; foul discharges with emaciation and great debility; dirtybrownish tongue; jet-black tongue; dusky, bluish or purplish color of the skin or mucous tissues, with a low form of inflammation. It is of special value in typhoid states, in which it is indicated by the prominent typhoid symptoms—dry tongue, sordes on tongue and teeth, mental disturbances, tympanites and diarrheal discharges—and in malignant carbuncle, pyosalpinx, and thecal abscesses. Action.—The physiological action of echinacea has never been satisfactorily determined. It has been held to increase phagocytosis and to improve both leukopenia and hyperleucocytosis. That it stimulates and hastens the elimination of waste is certain, and that it possesses some antibacterial power seems more than probable. Upon the mucous tissues echinacea causes a quite persistent disagreeable tingling sensation somewhat allied to, but less severe, than that of prickly ash and aconite. It increases the salivary and the urinary flow, but sometimes under diseased conditions anuria results while it is being administered. In the doses usually given no decided unpleasant symptoms have been produced; and no reliable cases of fatal poisoning in human beings have been recorded from its use. Occasionally bursting headache, joint pains, dry tongue, reduced temperature and gastro-intestinal disturbances with diarrhea are said to have resulted from large doses of the drug. Therapy.-External. Echinacea is a local antiseptic, stimulant, deodorant, and anesthetic. Alcoholic preparations applied to denuded surfaces cause considerable burning discomfort, but as soon as the alcohol is evaporated a sense of comfort and lessening of previous pain is experienced. Its deodorant powers are remarkable, especially when applied to foul surfaces, carcinomatous ulcerations, fetid discharges from the ears, and in gangrene. While not wholly masking the odor of cancer and gangrene it reduces it greatly, much to the comfort of the sick and the attendants. Echinacea is useful as an application where decay is imminent or taking place, reparative power is poor, and the discharges saneous and unhealthy. It is especially valuable in sluggish ulcers, bed sores, stinking tibial ulcers, and ulcers of the nasal mucosa, due either to ozaena or to syphilis. The greater the tendency to lifelessness and dissolution of the tissues and the more pronounced the fetid character of the discharges, the more applicable is echinacea. Used by spray it is effective to remove stench and to stimulate repair in tonsillitis, the angina of scarlatina, and though not alone capable of curing diphtheria, either by external or internal use, it stimulates the near-necrosed tissue to activity and overcomes the fetid odor, thus contributing in a large measure to aid more specific agents. A 10 to 50 per cent solution may be used to cleanse abscess cavities, to apply to ragged wounds from barbed wire, tin, and glass, wounds which for some reason are very painful and heal sluggishly. For this purpose we prefer Rx. Echafolta (or Echinacea), 1 fluidounce; Asepsin, 15 grains; Tincture of Myrrh, 2 fluidrachms; Sterile Water, enough to make 4 fluidounces. Mix. Apply upon sterile gauze, renewing at reasonable periods. This also makes a good mouth wash for foul breath and to remove odor and stimulate repair in pyorrhea alveolaris, spongy and bleeding gums, and aphthous and herpetic eruptions. Echinacea is sometimes of value in eczema, with glutinous, sticky exudation, and general body depravity; to give relief to pain and swelling in erysipelas, mammitis, orchitis, and epididymitis; to allay pain and lessen tumefaction in phlegmonous swellings; and to dress syphilitic phagedena. As a local application to chilblains it has done good service, and in poisoning by Rhus Toxicodendron is relied upon by many as one of the best of local medicines. We have found it especially useful in dermatitis venenata after denudation of the cuticle when ulcers form and the neighboring glands swell. Echinacea has a greater record for success than any single medicine for snake bites and insect bites and stings, and it may be used full strength to relieve the intolerable itching of urticaria. Some have asserted that it will abort boils. For the treatment of carbuncle, after thoroughly incising, a 50 per cent solution to full strength echinacea or echafolta may be freely used, syringing the channels with it. This gives great relief from pain ¹

IMPATIENS
   The plants Impatiens pallida, Nuttall; and Impatiens capensis, Meerb., (Nat. Ord. Balsaminaceae). Moist shady places and rich soils in the United States. Common Names: Balsam jewel Weed, Balsam Weed, Jewel Weed, (1) Pale TouchMe-Not, (2) Speckled Touch-Me-Not. Preparation.—The bruised, fresh plant. Action and Therapy.—External. Refrigerant and sedative. The fresh juice of the crushed Impatiens gives prompt relief in the dermatitis of rhus poisoning if used early. It also quickly relieves the intolerable stinging produced by nettles. As these plants usually grow contiguously the balsam can be procured and applied at once. The relief is almost magical. The bruised plants may also be used to relieve the pain of acute engorged hemorrhoids. INULA. The root of Inula Helenium, Linné (Nat. Ord. Compositae). A common roadside and pasture weed in Europe and America. Dose, 1 to 60 grains. Common Names: Elecampane, Scabwort. Principal Constituents.—Resins, inulin (30 to 40 per cent), a starch-like body, and helenin (Alant camphor). Preparations.—1. Specific Medicine Inula. Dose, 1 to 60 drops. 2. Syrupus Inula, Syrup of Inula, (Specific Medicine Inula, 1 fluidrachm; Syrup, 16 ounces). Dose, 1 to 4 fluidrachms. Specific Indications.—”Cough of a teasing and persistent character accompanied by substernal pain and profuse excretion; atony of abdominal viscera with engorgement and relaxation; catarrhal discharges." (American Dispensatory, 1900.) Action and Therapy.—Inula is an aromatic, stimulating expectorant and tonic. It is one of the old but neglected remedies of early domestic and eclectic development, and has recently been revived as a remedy of promise in chronic pulmonic disorders. As it acts kindly upon the stomach, it proves tonic and favors digestion and assimilation. It seems especially adapted to chronic disorders with excessive mucous discharges. It has long been valued in chronic catarrhal states of the bronchi, bladder, and vagina, and particularly in chronic endometritis with discharge of glairy mucus. It relieves some cases of humid asthma and controls night sweats. Inula is of greatest service in bronchial irritation, with cough of a persistent, teasing character, with copious expectoration. We have for many years used and valued the syrup advised by Locke, and prepared as follows: Take Elecampane, 1 ounce; Boiling Water, 16 fluidounces. Boil until but 8 ounces remain; add 1/2 pound of white sugar. This is especially useful in chronic bronchitis, with profuse excretion of mucus or muco-pus, and in the cough persisting after la grippe and the severest forms of colds. From time to time reports have come to press that helenin and other constituents of inula are fatal to the tubercle bacillus. In 1900 we recorded in the American Dispensatory the statement that “helenin is accredited with a fatal action upon the tubercle bacillus by Korab, Blocq, and others.” Locke, in his lectures, emphasized the value of Inula in phthisis, and noted particularly its value to control the night sweats of that disorder. This was recorded in Locke’s Syllabus in 1895. More recently, since hypodermatic and intravenous medication have come into vogue, inula, together with echinacea, has been reinvestigated and advised as a potent drug for its influence upon pulmonary tuberculosis. This work is still in the experimental stage, but with promise at least of amelioration of symptoms and gain of weight in some cases and a marked lessening of cough and secretion. Over-enthusiastic reports must be received with judgment, and not too much hoped for until more complete knowledge of its power over tuberculosis is proved or disproved. The value of the drug, internally administered, so far as amelioration of distressing symptoms is concerned, is unquestioned, but so far we are skeptical concerning its power to destroy the tubercle bacillus within the body.¹