Rhus Toxicodendron

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

RHUS TOXICODENDRON
   The fresh leaves of Toxicodendron radicans (L.) Kuntze (Rhus radicans, Linné, Rhus Toxicodendron, Linné) (Nat. Ord. Anacardiaceae) A common indigenous plant in fields, woods, and fence rows. Common Names: Poison Ivy, Poison Vine, Poison Oak. Principal Constituents.—A volatile toxicodendric acid, and the poisonous toxicodendrol, a non-volatile oil soluble in alcohol, and forming an insoluble lead compound with lead acetate, hence the use of an alcoholic solution of the lead salt to remove it and prevent poisoning or its extension. It is allied to cardol found in cashew-nut. Preparation.-Specific Medicine Rhus. Dose, 1/20 to 5 drops. Specific Indications.—The chief and most direct indication is the long pointed tongue with prominent papillae, associated with burning heat, and redness and great unrest. Others are: The moderately quick, small, sharp pulse, sometimes wiry, sometimes vibratile; great restlessness with or without vomiting; child starts from sleep with a shrill cry as if from fright; tongue red and irritable, exhibiting red spots; strawberry tongue; pain over left orbit; burning pain; rheumatic pain aggravated by warmth; pinched countenance; burning pain in the urethra with dribbling of urine; acrid discharges from the bladder or bowels; tympanites; brown sordes; bright, superficial redness of the skin with burning, itching, or tingling; red glistening erysipelas, with burning pain; redness of mucous surfaces; conjunctival inflammation with pain, photophobia, and burning lachrimation; inflammation with bright-red tumid surfaces and deep-seated burning pain; tumid red swellings; inflammation with ichorous discharges, the tissues seemingly melting away; old ulcers with shining red edges; induration of the submaxillary glands. Action and Toxicology.—Internally, administered in small doses, Rhus Toxicodendron is slightly stimulant, increasing the renal and cutaneous secretions, and proving feebly laxative. Employed in paralytic states it is reputed to have effected a return of sensation and power of movement, the good effects being ushered in with a sensation of pricking and burning, with twitchings of the affected parts. Large doses occasion stupefaction, or a sort of intoxication, exhibited by vertigo, impairment of the special senses, pupillary dilatation, chilliness, sickness at the stomach with thirst and burning pain, and a feeling of constriction in the temporal regions. The pulse becomes slow, irregular and small, the activity of the skin and kidneys increases, weakness, trembling, and fainting occur, and sometimes convulsions ensue. A pint of rhus berries induced drowsiness, stupor, delirium, and convulsions in two children who partook of them. The infusion of the root taken internally is asserted to have produced the characteristic local eruptions, besides producing a harsh cough, scanty urine, and severe gastrointestinal symptoms. Locally, rhus is a powerful irritant poison. The toxic manifestations produced by the different species are of precisely the same nature, differing only in degree of intensity. Rhus Toxicodendron ranks next to poison dogwood (Rhus venenata) in point of virulence. While locally poisonous to some persons, others are totally unaffected by it. Many are but mildly poisoned by it; many more, however, show serious evidence of its great activity. Contact is not always necessary to obtain its effects. Indeed, many individuals apparently are poisoned merely by exposure to an atmosphere contaminated with the toxic exhalations of the plant. This is especially true when the air is heavy and humid, or when the susceptible individual is freely perspiring. Alcoholic solution of the toxic principle retains its virulence for many years (Johnson). The dried leaves are, as a rule, inert. A singular feature connected with rhus poisoning is its recurrence from month to month, and from year to year, even when the affected individual is far remote from all exhalations of the plant. This was early noted by Barton, who personally experienced such recurrence for five successive years-a portion of which time was passed in Europe far from proximity to the plant in question. We have also observed this phenomenon. The smoke from burning rhus wood was noticed as early as 1720 by Sherard, Wangenheim, and Kalm, to produce poisonous effects. It appears that horses eat the plant with impunity (Barton). According to William Bartram, they are very fond of the leaves. Cows are wholly unaffected by the ingestion of the plant. Thunberg observed that sheep ate of the leaves of Rhus lucidum, a similar species, without harm. To dogs and guinea pigs, on the other hand, poison vine is fatal. The statement that the infusion of the leaves was administered to consumptives with non-poisonous results may seem contradictory, but we cannot but believe that a portion of the poisonous principle is volatile, in spite of the assertion that non-volatile toxicodendrol is the toxic agent, and consequently driven off in heating. The nature of poisoning by rhus has always partaken somewhat of the mysterious, and it has been the subject of much speculation. Various reasons have been assigned as to why it poisons at all, and as to why it affects only certain individuals. It has been customary to attribute the deleterious effects to emanations from the living plant. Later, Prof. Maisch announced a volatile substance of acid character as the offender, and named it toxicodendric acid. Still later, a bacterium was charged with creating the mischief. The latter cause, however, has now been satisfactorily disproved. An oil has now been isolated, and this, even when purified, excites exactly the same form of dermatitis as the growing plant. This discovery was made in 1895 by Dr. Franz Pfaff, of Harvard University. It is present in every part of the ivy plant, and even the dried wood is said to retain it. It has been named toxicodendrol, and is asserted to be in reality the only tangible substance found thus ¹