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

LEPTANDRA (Veronicastrum virginicum)^VEVI4
   The rhizome and rootlets of Veronicastrum virginicum (L.) Farw., (Leptandra virginica, Nuttall), (Nat. Ord. Scrophulariaceae). A tall perennial plant indigenous to the eastern half of the United States. Dose, 10 to 60 grains. Common Names: Culver's Root, Black Root, Culver's Physic, Bowman Root, Tall Speedwell, etc. Principal Constituents.—A resinoid called leptandrin, formerly used but now largely discarded by Eclectic practitioners, and a bitter principle. Preparation.—Specific Medicine Leptandra. Dose, 1 to 60 drops. Derivative.—Leptandrin (Resinoid). Dose, 1/4 to 2 grains. Specific Indications.—Tenderness and heavy pain in the region of the liver, with drowsiness, dizziness, and mental depression; skin, yellow; tongue coated white; bitter taste, nausea, frontal headache and cold extremities; thirst with inability to drink; diarrhea with half-digested passages, or clay-colored stools; enfeebled portal circulation, with lassitude, gloom, and mental depression. Action and Therapy.—Leptandra is a gastro-hepatic and intestinal stimulant. The fresh root is viciously cathartic and has produced bloody stools and abortion. Drying, however, deprives the drug of its drastic quality and it becomes a safe cholagogue, laxative, and cathartic. Apparently in ordinary doses it strengthens the functional activity of the intestinal glands, does not debilitate nor produce large stools, and if the circulation is feeble, with a tendency to stasis, it has a decidedly tonic effect. Leptandra is a remedy for intestinal atony—especially duodenal atony associated with hepatic torpor. It has been employed in dysentery and chronic diarrhoea, dependent upon constipation of the upper bowel, or upon imperfect elaboration of the food. These cases are accompanied by dizziness, headache, visceral pain, mental depression and cold extremities. In atony of the stomach and liver with the preceding and the following symptoms it is decidedly stimulant and tonic. There is a dry, hot skin, with cold feet, abdominal plethora, pale, white coated or furred broad and thick tongue, heavy or dull aching in the hepatic region and the left shoulder, and a bitter, disagreeable taste. In fact with any of the preceding symptoms—and yellowness of the skin and conjunctiva and nausea, leptandra will prove very useful in atonic dyspepsia, acute hepatitis, acute duodenal catarrh, diarrhea of halfdigested aliment, muco-enteritis, and chronic enteritis. It will be evident from the guides given that leptandra, is a remedy for the complex known as “biliousness”. It aids chionanthus, and sometimes podophyllin to dissipate jaundice. In the early period of Eclectic medicine it was valued in typhoid fever, when ushered in with constipation and before marked involvement of Peyer’s patches had become established. It is questionable whether any laxative should be resorted to in such conditions—an enema is to be preferred. But for pre-typhoid symptoms, not amounting to enteric fever, its use is justifiable and even beneficial. Leptandra is better as a laxative in malarial fever and prepares the system for the more kindly reception of antiperiodic medication. It is no longer employed in anasarca and ascites, better agents having supplanted it. It is a good medicine and its field of usefulness has narrowed down to gastro-hepato-duodenal atony, and attendant or resulting disorders, in which it proves an admirable stimulant and corrective. It acts well with hydrastis, podophyllum, chionanthus, dioscorea, or chelidonium when these are also indicated. It is especially valuable in the diarrhoea of dentition. The nervous irritability may be controlled with matricaria and the following administered: Rx Compound Syrup of Rhubarb and Potassa, 3 fluidrachms; Specific Medicine Leptandra, 1 fluidrachm. Mix. Ten to 20 drops every hour until the diarrhea ceases. Glyconda may be substituted for the neutralizing cordial, if sugar is contraindicated.¹