Digitalis
An arrhythmia is a problem with the rate or rhythm of your heartbeat. It means that your heart beats too quickly, too slowly, or with an irregular pattern. When the heart beats faster than normal, it is called tachycardia. When the heart beats too slowly, it is called bradycardia. The most common type of arrhythmia is atrial fibrillation, which causes an irregular and fast heart beat.
Many factors can affect your heart's rhythm, such as having had a heart attack, smoking, congenital heart defects, and stress. Some substances or medicines may also cause arrhythmias.
Symptoms of arrhythmias include:
- Fast or slow heart beat
- Skipping beats
- Lightheadedness or dizziness
- Chest pain
- Shortness of breath
- Sweating
Your doctor can run tests to find out if you have an arrhythmia. Treatment to restore a normal heart rhythm may include medicines, an implantable cardioverter-defibrillator (ICD) or pacemaker, or sometimes surgery.
NIH: National Heart, Lung, and Blood Institute
WARNING: All medicines, drugs, plants, chemicals or medicial precedures below are for historical reference only. Many of these treatments are now known to be harmful and possibly fatal. Do not consume any plant, chemical, drug or otherwise without first consulting a licensed physician that practices medine in the appropriate field.
Felter's Materia Medica on Digitalis
ADONIS VERNALIS
The whole plant of Adonis vernalis, Linné. (Nat. Ord. Ranunculaceae). Southern Europe, Siberia, and Labrador. Dose, 1/2 to 3 grains. Common Name: Pheasant's Eye. Principal Constituent.Adonidin, probably a mixture of acids and glucosides. Preparation.Specific Medicine Adonis. Dose, 1/2 to 3 drops. Specific Indications.Weak cardiac action, with low blood pressure, and shortened diastole, with consequent venous stasis, with increased back-pressure, and feeble intermittent or irregular pulse; cardiac dropsy, with weak heart. Action.Fresh adonis is irritant and vesicant. Upon the circulation it acts much like digitalis, but is prompter in action and not cumulative. It is an energetic agent and capable of poisoning. Adonis slows, regulates, and strengthens the heart's contractions, raises blood pressure, and thereby acts as a diuretic. It also causes deeper and slower breathing, and in proper cases overcomes dyspnea. Large doses paralyze the heart and blood vessels. Therapy.On account of its quicker action Adonis has been preferred by some to digitalis and strophanthus in the same class of heart affections to which these are applicable, or in which for some reason it is undesirable to employ them. It is especially commended where arryrthmia with feeble cardiac force and dyspnoea and dropsy are present. It has long been a popular remedy in Russia for dropsies of both heart and kidney origin. It is probably less valuable than digitalis where the cardiac valves are greatly affected. Scudder valued adonis in heart-strain from overexertion; Hale recommended it in endocarditis and in weak and irregular heart action resulting from chronic nephritis. Wilcox used it in chronic albuminuria, with pale urine and delirium with good results and in uremic convulsions, which had been frequent, without a return of the eclampsia for two years, when the patient died. It is undoubtedly emmenagogue and has been advised in epilepsy, administering it with bromide of potassium. It should not be given when there is gastro-intestinal irritation or inflammation. 1
The whole plant of Adonis vernalis, Linné. (Nat. Ord. Ranunculaceae). Southern Europe, Siberia, and Labrador. Dose, 1/2 to 3 grains. Common Name: Pheasant's Eye. Principal Constituent.Adonidin, probably a mixture of acids and glucosides. Preparation.Specific Medicine Adonis. Dose, 1/2 to 3 drops. Specific Indications.Weak cardiac action, with low blood pressure, and shortened diastole, with consequent venous stasis, with increased back-pressure, and feeble intermittent or irregular pulse; cardiac dropsy, with weak heart. Action.Fresh adonis is irritant and vesicant. Upon the circulation it acts much like digitalis, but is prompter in action and not cumulative. It is an energetic agent and capable of poisoning. Adonis slows, regulates, and strengthens the heart's contractions, raises blood pressure, and thereby acts as a diuretic. It also causes deeper and slower breathing, and in proper cases overcomes dyspnea. Large doses paralyze the heart and blood vessels. Therapy.On account of its quicker action Adonis has been preferred by some to digitalis and strophanthus in the same class of heart affections to which these are applicable, or in which for some reason it is undesirable to employ them. It is especially commended where arryrthmia with feeble cardiac force and dyspnoea and dropsy are present. It has long been a popular remedy in Russia for dropsies of both heart and kidney origin. It is probably less valuable than digitalis where the cardiac valves are greatly affected. Scudder valued adonis in heart-strain from overexertion; Hale recommended it in endocarditis and in weak and irregular heart action resulting from chronic nephritis. Wilcox used it in chronic albuminuria, with pale urine and delirium with good results and in uremic convulsions, which had been frequent, without a return of the eclampsia for two years, when the patient died. It is undoubtedly emmenagogue and has been advised in epilepsy, administering it with bromide of potassium. It should not be given when there is gastro-intestinal irritation or inflammation. 1
APOCYNUM CANNABINUM
The root of Apocynum cannabinum, Linné (Nat. Ord. Apocynaceae) gathered in autumn after the leaves and fruit have matured. Grows throughout the United States. Dose, 1 to 20 grains. Common Names: Bitter Root, Canadian Hemp, and improperly, Indian Hemp. Principal Constituents.A resinous principleapocynin, and a yellow glucoside, apocynein; and apocynamarin, or cynotoxin, or cymarin, all of which resemble digitalis glucosides in action. Preparations.-1. Specific Medicine Apocynum. Dose, 1/4 to 20 drops. Usual form of administration: Rx Specific Medicine Apocynum, 10 drops to 1 fluidrachm; Water, four ounces; Mix. Sig. One teaspoonful every 1 to 3 hours. 2. Decoctum Apocyni, Decoction of Apocynum (root 1 ounce to Water, 16 ounces). Dose, 1 to 2 fluidrachms. Specific Indications.Watery infiltration of cellular tissueedema with weak circulation and general debility; skin blanched, full, smooth, and easily indented; puffiness under the eyes; eyelids wrinkled, as if parts had been recently swollen; feet full and edematous, pitting upon pressure; constipation, with edema; urine scanty and circulation sluggish; boggy, watery uterus; full relaxed uterus with watery discharge; profuse menorrhagia, too often and too long continued; passive hemorrhages, small in amount and associated with pedal edema; mitral and tricuspid regurgitation, with rapid and weak heart action, low arterial tension, difficult breathing, cough, and tendency to cyanosis. Action.Apocynum acts powerfully upon the heart, slowing its action and raising arterial tension. The cardiac muscle appears to be directly stimulated by it as are probably the arterial coats. Contraction of the renal arteries also takes place, so that while less blood passes at a time through the kidneys, the act of filtration is more perfect and marked diuresis results. Though long known that diuresis was one of its most prominent results, the knowledge that this is due to the better cardiac pressure and arterial tonus, rather than to the increased intrinsic secreting power of the renal glomeruli, is the result of pharmacologic investigation in recent years, particularly the work of Horatio C. Wood, Jr. The general effects upon man of full doses of apocynum are nausea, and sometimes vomiting and purging, succeeded by copious sweating. The pulse is then depressed, and in some a disposition to drowsiness is observed until relieved by vomiting. The powdered drug causes sneezing. The small doses employed in Eclectic therapeutics seldom occasion any of the above-named symptoms save that of severe watery purging, which may occur suddenly, when the drug has been administered persistently for several weeks. Therapy.No remedy in the Eclectic materia medica acts with greater certainty than does apocynum. In former times it was employed in heroic doses chiefly for its hydragogue cathartic and diuretic effects. Early in the last century it was employed by the botanic practitioners for the relief of dropsy. Later the Eclectic school developed its specific uses in dropsy and affections of the heart and circulation. Like many similar drugs, the powder was employed as a sternutatory in the days when it was believed that such effects as the increasing of the nasal discharges was the best way to relieve headaches and certain catarrhal affections. Again, it was recommended in diaphoretic doses, for the relief of intermittent and remittent fevers, and in pneumonic involvements, conditions in which it is now seldom or never thought of. It is rarely employed nowadays as a cathartic, and then only in dropsical conditions, as other hydragogues have been similarly used. Such is the use of it advocated by the authors of the regular school of medicine, by those who use it at all; and from such a use arises the criticisms frequently indulged in in condemnation of the drug. Eclectics do not use it in this manner. Specific medication has established that this action is not necessary, for when specifically indicated it promptly removes effusions without resorting to cathartic doses. Consequently it finds little use as a cathartic, except very rarely as recommended by Goss, for the removal of ascarides. To use apocynum intelligently and successfully, the prescriber must recognize, first, that debility is the condition in which it exerts its specific and beneficial effectsdebility of the heart and circulatory apparatus, of the kidneys, of the capillaries of the skin particularly. In such a state it will prove a remedy; under opposite conditions it is likely to prove an aggravation. The patient with a strong, rope-like, hard, and quick pulse is not the patient for apocynum. On the other hand, the feeble pulse, soft and of little force, indicates its selection as the remedial agent. The atonic state which readily permits of exudation from the blood vessels is the ideal condition which we seek to remedy with apocynum. It is a vascular stimulant. Such results one would not expect to obtain if there were circulatory obstruction or active fever. The only apparent exception, in which it is adapted to active conditions, is that reported by Webster of its efficacy in active inflammation of the upper pharyngeal and post-nasal tract, where, he declares, it rivals phytolacca in its results. One can not expect apocynum to reconstruct wornout tissues or to restore damaged vascular valves. We must not hope to work miracles with it where there are such structural lesions as incurable or malignant organic diseases of the heart, liver, or kidneys. Yet in these conditions, when debility and subcutaneous, watery exudation are strong factors, it alone is a powerful remedy to relieve urgent symptoms and to put into action that portion of sound tissue that remains. The most we can hope for is an amelioration of the symptoms, and a notable decrease of the watery accumulation may be looked for. Under these circumstances we have removed enormous dropsical swellings with it, giving quick relief from dyspnea and1
The root of Apocynum cannabinum, Linné (Nat. Ord. Apocynaceae) gathered in autumn after the leaves and fruit have matured. Grows throughout the United States. Dose, 1 to 20 grains. Common Names: Bitter Root, Canadian Hemp, and improperly, Indian Hemp. Principal Constituents.A resinous principleapocynin, and a yellow glucoside, apocynein; and apocynamarin, or cynotoxin, or cymarin, all of which resemble digitalis glucosides in action. Preparations.-1. Specific Medicine Apocynum. Dose, 1/4 to 20 drops. Usual form of administration: Rx Specific Medicine Apocynum, 10 drops to 1 fluidrachm; Water, four ounces; Mix. Sig. One teaspoonful every 1 to 3 hours. 2. Decoctum Apocyni, Decoction of Apocynum (root 1 ounce to Water, 16 ounces). Dose, 1 to 2 fluidrachms. Specific Indications.Watery infiltration of cellular tissueedema with weak circulation and general debility; skin blanched, full, smooth, and easily indented; puffiness under the eyes; eyelids wrinkled, as if parts had been recently swollen; feet full and edematous, pitting upon pressure; constipation, with edema; urine scanty and circulation sluggish; boggy, watery uterus; full relaxed uterus with watery discharge; profuse menorrhagia, too often and too long continued; passive hemorrhages, small in amount and associated with pedal edema; mitral and tricuspid regurgitation, with rapid and weak heart action, low arterial tension, difficult breathing, cough, and tendency to cyanosis. Action.Apocynum acts powerfully upon the heart, slowing its action and raising arterial tension. The cardiac muscle appears to be directly stimulated by it as are probably the arterial coats. Contraction of the renal arteries also takes place, so that while less blood passes at a time through the kidneys, the act of filtration is more perfect and marked diuresis results. Though long known that diuresis was one of its most prominent results, the knowledge that this is due to the better cardiac pressure and arterial tonus, rather than to the increased intrinsic secreting power of the renal glomeruli, is the result of pharmacologic investigation in recent years, particularly the work of Horatio C. Wood, Jr. The general effects upon man of full doses of apocynum are nausea, and sometimes vomiting and purging, succeeded by copious sweating. The pulse is then depressed, and in some a disposition to drowsiness is observed until relieved by vomiting. The powdered drug causes sneezing. The small doses employed in Eclectic therapeutics seldom occasion any of the above-named symptoms save that of severe watery purging, which may occur suddenly, when the drug has been administered persistently for several weeks. Therapy.No remedy in the Eclectic materia medica acts with greater certainty than does apocynum. In former times it was employed in heroic doses chiefly for its hydragogue cathartic and diuretic effects. Early in the last century it was employed by the botanic practitioners for the relief of dropsy. Later the Eclectic school developed its specific uses in dropsy and affections of the heart and circulation. Like many similar drugs, the powder was employed as a sternutatory in the days when it was believed that such effects as the increasing of the nasal discharges was the best way to relieve headaches and certain catarrhal affections. Again, it was recommended in diaphoretic doses, for the relief of intermittent and remittent fevers, and in pneumonic involvements, conditions in which it is now seldom or never thought of. It is rarely employed nowadays as a cathartic, and then only in dropsical conditions, as other hydragogues have been similarly used. Such is the use of it advocated by the authors of the regular school of medicine, by those who use it at all; and from such a use arises the criticisms frequently indulged in in condemnation of the drug. Eclectics do not use it in this manner. Specific medication has established that this action is not necessary, for when specifically indicated it promptly removes effusions without resorting to cathartic doses. Consequently it finds little use as a cathartic, except very rarely as recommended by Goss, for the removal of ascarides. To use apocynum intelligently and successfully, the prescriber must recognize, first, that debility is the condition in which it exerts its specific and beneficial effectsdebility of the heart and circulatory apparatus, of the kidneys, of the capillaries of the skin particularly. In such a state it will prove a remedy; under opposite conditions it is likely to prove an aggravation. The patient with a strong, rope-like, hard, and quick pulse is not the patient for apocynum. On the other hand, the feeble pulse, soft and of little force, indicates its selection as the remedial agent. The atonic state which readily permits of exudation from the blood vessels is the ideal condition which we seek to remedy with apocynum. It is a vascular stimulant. Such results one would not expect to obtain if there were circulatory obstruction or active fever. The only apparent exception, in which it is adapted to active conditions, is that reported by Webster of its efficacy in active inflammation of the upper pharyngeal and post-nasal tract, where, he declares, it rivals phytolacca in its results. One can not expect apocynum to reconstruct wornout tissues or to restore damaged vascular valves. We must not hope to work miracles with it where there are such structural lesions as incurable or malignant organic diseases of the heart, liver, or kidneys. Yet in these conditions, when debility and subcutaneous, watery exudation are strong factors, it alone is a powerful remedy to relieve urgent symptoms and to put into action that portion of sound tissue that remains. The most we can hope for is an amelioration of the symptoms, and a notable decrease of the watery accumulation may be looked for. Under these circumstances we have removed enormous dropsical swellings with it, giving quick relief from dyspnea and1
ASCLEPIAS INCARNATA
The root of Asclepias incarnata, Linné (Nat. Ord. Asclepiadaceae). Common in damp and wet grounds throughout the United States. Dose, 1 to 60 grains. Common Names: Flesh-colored Asclepias, Swamp Milkweed, Swamp Silkweed, White Indian Hemp, Rose-colored Silkweed. Principal Constituents.A fixed and a volatile oil, two acrid resins, and an unstable amorphous alkaloid asclepiadine, resembling emetine in action. Preparation.Specific Medicine Swamp Milkweed. Dose, 1 to 60 drops. Action and Therapy.Diuretic and vermifuge. There is good reason to believe this agent a good diuretic to be substituted for digitalis in cases of edema dependent upon cardiac insufficiency. Its action is similar to that of foxglove, without the irritating effects upon the gastric membranes. In fact, in small doses it is a stomachic and of some value in chronic catarrh of the stomach. In powder, 10 to 20 grains, 3 times a day, it is said to expel lumbricoids. 1
The root of Asclepias incarnata, Linné (Nat. Ord. Asclepiadaceae). Common in damp and wet grounds throughout the United States. Dose, 1 to 60 grains. Common Names: Flesh-colored Asclepias, Swamp Milkweed, Swamp Silkweed, White Indian Hemp, Rose-colored Silkweed. Principal Constituents.A fixed and a volatile oil, two acrid resins, and an unstable amorphous alkaloid asclepiadine, resembling emetine in action. Preparation.Specific Medicine Swamp Milkweed. Dose, 1 to 60 drops. Action and Therapy.Diuretic and vermifuge. There is good reason to believe this agent a good diuretic to be substituted for digitalis in cases of edema dependent upon cardiac insufficiency. Its action is similar to that of foxglove, without the irritating effects upon the gastric membranes. In fact, in small doses it is a stomachic and of some value in chronic catarrh of the stomach. In powder, 10 to 20 grains, 3 times a day, it is said to expel lumbricoids. 1
BUCHU (Barosma)AGBE2
The dried leaves of (1) Barosma betulina (Thunberg), Bartling and Wendland, or of (2) Barosma serratifolia (Curtis), Willdenow. (Nat. Ord. Rutaceae.) South Africa. Dose, 5 to 60 grains. Common Names: Buchu; (1) Short Buchu; (2) Long Buchu. Principal Constituents.A volatile oil, with a penetrating peppermint-like aroma, yielding diosphenol (C14 H22 O3), or barosma camphor, which may be obtained in colorless needles, of a peppermint taste. Preparation.Specific Medicine Barosma. Dose, 1 to 60 drops. Specific Indications.Abnormally acid urine, with constant desire to urinate with but little relief from micturition; vesico-renal irritation, with catarrhal secretion; copious mucous or muco-purulent discharges; cystorrhea. Action.Buchu increases the appetite, slightly quickens the circulation, and disinfects the urinary tract. It has but slight effect upon the renal organs, but such as it has is to stimulate slightly the output of both liquids and solids. It acts feebly upon the skin, increasing secretion. Large dose may produce gastro-enteritis and strangury. Therapy.Buchu is an aromatic stimulant, tonic, and urinary antiseptic. As a diuretic its action is not pronounced, but it is frequently used with other agents, as citrate or acetate of potassium, digitalis, or spirit of nitrous ether, which make it more efficient for the purposes of renal depuration. Buchu disinfects the urinary tract, imparting its aroma to the urine, and is to be used only in chronic conditions when there is an excess of mucus, or muco-purulent and acid urine, with vesico-renal irritation. Acid and muddy urine, loaded with urinary salts, and continual urging to urinate with but little relief from the effort, are the cases in which buchu renders good service. Under these circumstances it may be given in chronic cystitis, pyelitis, urethritis, prostatitis, lithaemia, and chronic vesical irritation. For catarrh of the bladder it is frequently effective, and in long standing irritation of the viscus, particularly in old persons, buchu and iron once a popular fad, is really of service. Rx Specific Medicine Barosma, 3 1/2 fluidounces; Tincture of Chloride of Iron, 1/2 fluidounce. Mix. Sig.: One teaspoonful 4 times a day in a wineglassful of infusion of hops, or of sweetened water. Occasionally it is used in dyspeptic conditions and in bronchial catarrh, but for these disorders we have far better remedies. Buchu renders the urine dark, the latter depositing a brownish precipitate. It should never be used in acute disorders.1
The dried leaves of (1) Barosma betulina (Thunberg), Bartling and Wendland, or of (2) Barosma serratifolia (Curtis), Willdenow. (Nat. Ord. Rutaceae.) South Africa. Dose, 5 to 60 grains. Common Names: Buchu; (1) Short Buchu; (2) Long Buchu. Principal Constituents.A volatile oil, with a penetrating peppermint-like aroma, yielding diosphenol (C14 H22 O3), or barosma camphor, which may be obtained in colorless needles, of a peppermint taste. Preparation.Specific Medicine Barosma. Dose, 1 to 60 drops. Specific Indications.Abnormally acid urine, with constant desire to urinate with but little relief from micturition; vesico-renal irritation, with catarrhal secretion; copious mucous or muco-purulent discharges; cystorrhea. Action.Buchu increases the appetite, slightly quickens the circulation, and disinfects the urinary tract. It has but slight effect upon the renal organs, but such as it has is to stimulate slightly the output of both liquids and solids. It acts feebly upon the skin, increasing secretion. Large dose may produce gastro-enteritis and strangury. Therapy.Buchu is an aromatic stimulant, tonic, and urinary antiseptic. As a diuretic its action is not pronounced, but it is frequently used with other agents, as citrate or acetate of potassium, digitalis, or spirit of nitrous ether, which make it more efficient for the purposes of renal depuration. Buchu disinfects the urinary tract, imparting its aroma to the urine, and is to be used only in chronic conditions when there is an excess of mucus, or muco-purulent and acid urine, with vesico-renal irritation. Acid and muddy urine, loaded with urinary salts, and continual urging to urinate with but little relief from the effort, are the cases in which buchu renders good service. Under these circumstances it may be given in chronic cystitis, pyelitis, urethritis, prostatitis, lithaemia, and chronic vesical irritation. For catarrh of the bladder it is frequently effective, and in long standing irritation of the viscus, particularly in old persons, buchu and iron once a popular fad, is really of service. Rx Specific Medicine Barosma, 3 1/2 fluidounces; Tincture of Chloride of Iron, 1/2 fluidounce. Mix. Sig.: One teaspoonful 4 times a day in a wineglassful of infusion of hops, or of sweetened water. Occasionally it is used in dyspeptic conditions and in bronchial catarrh, but for these disorders we have far better remedies. Buchu renders the urine dark, the latter depositing a brownish precipitate. It should never be used in acute disorders.1
CACTUS (Selenicereus spp.)
The fresh, green stems and the flowers of Selenicereus grandiflorus (L.) Britt. & Rose (and other Selenicereus speciesMM) (Cereus grandiflorus, Miller and DeCandolle.) Native of Mexico and the West Indies; grows also in Italy; cultivated in greenhouses in the United States. Common Names: Night-blooming Cereus, Large-flowering Cactus, Sweet-scented Cactus. Principal Constituents.Cactus has not been satisfactorily analyzed. Preparation.Specific Medicine Cactus. Dose, 1 to 10 drops. Specific Indications.Impaired heart action, whether feeble, irregular, or tumultuous; cardiac disorders with mental depression, praecordial oppression, and apprehension of danger and death; nervous disorders with feeble heart action; tobacco-heart; hysteria with enfeebled circulation; vertex headache; vaso-motor spasms. Action.Cactus impresses the sympathetic nervous system, and is especially active in its power over the cardiac plexus. In sufficiently large doses it acts as an intense irritant to the cardiac ganglia, producing thereby irritability, hyperaesthesia, arrythmia, spasm and neuralgia of the heart, and even carditis and pericarditis. According to E. M. Hale, M.D., it acts. upon the circular cardiac fibers, whereas digitalis acts upon all the muscular fibers of the heart. Like the latter, as a secondary effect of over-stimulation, it may induce heart-failure. The tincture, in large doses, produces gastric, irritation, and also affects the brain, causing confusion of mind, hallucination, and slight delirium. In excessive doses, a quickened pulse, constrictive headache, or constrictive sensation in the chest, cardiac pain -with palpitation, vertigo, dimness of sight, over-sensitiveness to noises, and a disposition to be sad or to imagine evil, are among its many nervous manifestations. Melancholia often follows such action. It is contended by many that the mental, cerebral, gastric, and other effects are secondary to and dependent largely upon the primary effects of the drug upon the heart; others believe its action depends chiefly upon the nervous system. Therapy.Cactus is the remedy for enfeeblement of the heart. An old school writer of prominence has said of it that cactus is the only remedy that will quicken a slow heart. While there are some who declare cactus totally inert as a medicine, there are others who claim for it great value even in structural alterations of the heart. The verdict of Eclectic practitioners, who are the largest users of the drug, is that cactus is a remedy chiefly for functional disorders of the heart due to nervous origin. It is, therefore, a nerve remedy primarily and a heart remedy secondarily. Eclectics have also noted that it improves the nutrition of the heart muscle and thus is, in a measure, a structural remedy also. By improving the nutrition of the organ it is possible, in some instances, to correct structural abnormalities. Valvular troubles have been noted to gradually disappear under its prolonged administration. Unlike digitalis it does not disorder the stomach nor is it cumulative. Cactus acts upon the vessels through the vaso-motor apparatus. The peculiar state of the nervous system in cardiac diseases, calling for cactus, is quite characteristic. There is a marked mental depression, often amounting to hypochondria and fear of impending death. Associated with these are praecordial weight and oppression and difficult breathing. The control over the nervous system is somewhat like that of pulsatilla, and the effects of cactus are usually permanent. In medicinal doses, cactus diminishes the frequency of the pulse, and increases the renal secretions, and is, therefore, sedative and diuretic. According to Scudder (Specific Medication), it neither increases nor depresses innervation; that it is neither stimulant nor sedative. Locke, on the other hand, believes it sedative, but not depressant (Syllabus of Materia Medica). In such doses it does not appear to weaken the nervous system in the least. The special field for cactus is diseases of the heart. Its influence upon the heart is manifested when the disorder is functional; organic conditions are only benefited in a measure. However, some who are antagonists of Eclectic medicine, who are generally skeptical regarding the virtues of plants which do not possess unusually powerful properties, consider cactus as a valuable agent in mitral regurgitation, due to valvular lesions. In our school, however, let us repeat, it is recognized chiefly as a functional remedy, and one of the best of cardiac tonics. There is no doubt but that the continued use of the drug tends to increase cardiac nutrition and waste, and in this way may benefit cases with structural lesions. The influence of cactus is believed to be exerted almost wholly upon the sympathetic nervous system, through the superior cervical ganglia, expending its force in regulating the action of the heart and controlling the cerebral circulation, thus giving increased nutrition to the brain. It is the remedy for most functional cardiac irregularities, as palpitation, pain, cardiac dyspnea, intermission. in rhthym, etc. Even in structural heart-wrongs, the majority of unpleasant symptoms are partly due to disordered innervation, and this condition is corrected by cactus. It does not seem to make any difference whether the heart-action be feeble, violent, or irregular, provided it be due to lack of innervation, associated with mental depression, or in excitable or nervous individuals, the remedy relieves, because its tendency is to promote normal rhythmic action of the cardiac muscle. Aortic regurgitation is nearly always benefited by it and it is useful in progressive valvular weakness, but is contraindicated in stenotic conditions. In spasm of the heart-muscle, and in cardiac pain of a constrictive character, as if the organ were held with a strong band, it is often the most prompt of all cardiac remedies. It is a good remedy in the heart troubles produced by to1
The fresh, green stems and the flowers of Selenicereus grandiflorus (L.) Britt. & Rose (and other Selenicereus speciesMM) (Cereus grandiflorus, Miller and DeCandolle.) Native of Mexico and the West Indies; grows also in Italy; cultivated in greenhouses in the United States. Common Names: Night-blooming Cereus, Large-flowering Cactus, Sweet-scented Cactus. Principal Constituents.Cactus has not been satisfactorily analyzed. Preparation.Specific Medicine Cactus. Dose, 1 to 10 drops. Specific Indications.Impaired heart action, whether feeble, irregular, or tumultuous; cardiac disorders with mental depression, praecordial oppression, and apprehension of danger and death; nervous disorders with feeble heart action; tobacco-heart; hysteria with enfeebled circulation; vertex headache; vaso-motor spasms. Action.Cactus impresses the sympathetic nervous system, and is especially active in its power over the cardiac plexus. In sufficiently large doses it acts as an intense irritant to the cardiac ganglia, producing thereby irritability, hyperaesthesia, arrythmia, spasm and neuralgia of the heart, and even carditis and pericarditis. According to E. M. Hale, M.D., it acts. upon the circular cardiac fibers, whereas digitalis acts upon all the muscular fibers of the heart. Like the latter, as a secondary effect of over-stimulation, it may induce heart-failure. The tincture, in large doses, produces gastric, irritation, and also affects the brain, causing confusion of mind, hallucination, and slight delirium. In excessive doses, a quickened pulse, constrictive headache, or constrictive sensation in the chest, cardiac pain -with palpitation, vertigo, dimness of sight, over-sensitiveness to noises, and a disposition to be sad or to imagine evil, are among its many nervous manifestations. Melancholia often follows such action. It is contended by many that the mental, cerebral, gastric, and other effects are secondary to and dependent largely upon the primary effects of the drug upon the heart; others believe its action depends chiefly upon the nervous system. Therapy.Cactus is the remedy for enfeeblement of the heart. An old school writer of prominence has said of it that cactus is the only remedy that will quicken a slow heart. While there are some who declare cactus totally inert as a medicine, there are others who claim for it great value even in structural alterations of the heart. The verdict of Eclectic practitioners, who are the largest users of the drug, is that cactus is a remedy chiefly for functional disorders of the heart due to nervous origin. It is, therefore, a nerve remedy primarily and a heart remedy secondarily. Eclectics have also noted that it improves the nutrition of the heart muscle and thus is, in a measure, a structural remedy also. By improving the nutrition of the organ it is possible, in some instances, to correct structural abnormalities. Valvular troubles have been noted to gradually disappear under its prolonged administration. Unlike digitalis it does not disorder the stomach nor is it cumulative. Cactus acts upon the vessels through the vaso-motor apparatus. The peculiar state of the nervous system in cardiac diseases, calling for cactus, is quite characteristic. There is a marked mental depression, often amounting to hypochondria and fear of impending death. Associated with these are praecordial weight and oppression and difficult breathing. The control over the nervous system is somewhat like that of pulsatilla, and the effects of cactus are usually permanent. In medicinal doses, cactus diminishes the frequency of the pulse, and increases the renal secretions, and is, therefore, sedative and diuretic. According to Scudder (Specific Medication), it neither increases nor depresses innervation; that it is neither stimulant nor sedative. Locke, on the other hand, believes it sedative, but not depressant (Syllabus of Materia Medica). In such doses it does not appear to weaken the nervous system in the least. The special field for cactus is diseases of the heart. Its influence upon the heart is manifested when the disorder is functional; organic conditions are only benefited in a measure. However, some who are antagonists of Eclectic medicine, who are generally skeptical regarding the virtues of plants which do not possess unusually powerful properties, consider cactus as a valuable agent in mitral regurgitation, due to valvular lesions. In our school, however, let us repeat, it is recognized chiefly as a functional remedy, and one of the best of cardiac tonics. There is no doubt but that the continued use of the drug tends to increase cardiac nutrition and waste, and in this way may benefit cases with structural lesions. The influence of cactus is believed to be exerted almost wholly upon the sympathetic nervous system, through the superior cervical ganglia, expending its force in regulating the action of the heart and controlling the cerebral circulation, thus giving increased nutrition to the brain. It is the remedy for most functional cardiac irregularities, as palpitation, pain, cardiac dyspnea, intermission. in rhthym, etc. Even in structural heart-wrongs, the majority of unpleasant symptoms are partly due to disordered innervation, and this condition is corrected by cactus. It does not seem to make any difference whether the heart-action be feeble, violent, or irregular, provided it be due to lack of innervation, associated with mental depression, or in excitable or nervous individuals, the remedy relieves, because its tendency is to promote normal rhythmic action of the cardiac muscle. Aortic regurgitation is nearly always benefited by it and it is useful in progressive valvular weakness, but is contraindicated in stenotic conditions. In spasm of the heart-muscle, and in cardiac pain of a constrictive character, as if the organ were held with a strong band, it is often the most prompt of all cardiac remedies. It is a good remedy in the heart troubles produced by to1
CONIUM
The full grown fruit, gathered green, of Conium maculatum, Linné (Nat. Ord. Umbelliferae). Europe and Asia; naturalized in the United States. Common Names: Hemlock, Poison Hemlock, Spotted Hemlock. Principal Constituents.-Five alkaloids of which the intensely poisonous liquid coniine (C8H17N) is most important; the others are: conhydrine (C8H17NO), pseudoconhydrine (C8H17NO), methyl-coniine (C9H19N), and ethyl-piperidine (C7H15N). Preparation.Specific Medicine Conium. 1/30 to 3 drops. Specific Indications.Nervous excitation and excessive motility, with or without pain; neuralgic pain; pain in the aged, and when there are cacoplastic deposits; gastric pain; nervousness and restlessness; mild maniacal excitement; persistent spasmodic or hacking cough; enfeebled state of the sexual organs, with late and scanty menstruation. Action and Toxicology.Conium does not affect the intellectual portion of the brain; and it acts but feebly on the spinal cord. It does, however, powerfully depress the peripheral motor endings, and in excessive amounts, the sensory terminals. Only very large doses affect the circulation and the respiration, when blood pressure falls and respiration becomes paralyzed. The latter is the cause of death by conium and is due to the combined results of depression of the respiratory center in the medulla and the nervomuscular paralysis of the muscles of respiration. Involuntary muscles are not affected by conium, nor is the heart-muscle or nerves appreciably affected. Full doses of conium produce dryness of the throat and thirst, nausea, dizziness, sinking at the stomach, numbness, muscular relaxation, and depression of the circulation. Toxic amounts cause staggering gait, muscular heaviness and prostration, with failure of locomotion, ascending paralysis, difficult and labored articulation, dyspnea, dilated pupils, palpebral ptosis, and convulsions terminating in death. In rare instances coma ensues, but usually consciousness and the intellect remained unimpaired until death. The most marked symptoms of poisoning are the staggering gait, drooping eyelids, and ascending muscular prostration. In poisoning by conium the emetic may be used, but it is preferable to repeatedly wash out the stomach by means of the stomach pump. Artificial respiration and heat are to be used, and strychnine, atropine and digitalis, as well as the diffusible stimulants, to sustain respiration and the circulation. Therapy.External. Locally applied extract of conium, or the powdered drug, relieves the pain of cancerous growths and ulcers. Locke advised, Rx. English Extract of Conium, 2 drachms; Petrolatum, 6 ounces. Mix. Apply locally. Internal. Conium is a remedy for excessive motility and for pain. It also favors sleep, not because it is a hypnotic like opium, but because it relieves pain when that is the cause of the sleeplessness, or when due to an excitable action of the heart. It is also a remedy for the restlessness, with or without pain, associated with reproductive weakness, or due to sexual excesses. With this is a state of apathy, frequently frigidity in the female, and imperfect menstruation and leucorrheal discharges. The mentality is disturbed, often to the verge of mania. In such mild forms of nervous unrest and excitability small doses of conium will render good service. Chorea is one of the incoordinate disorders that is sometimes relieved by conium, but not all cases respond to it. It has been advised in tetanus, but is insufficient except in doses which would be equally as dangerous as the disorder itself . It is better adapted to control the excessive movements of hysteria and mania, but in the former having little effect upon the psychic phase of the disorder. It has been used in teething, when twitching of the muscles is present, in laryngismus stridulus, also in whoopingcough, but we have safer and more satisfactory remedies for these affections. Some cases of epilepsy due to masturbation have been relieved by conium, and it lessens the movements of paralysis agitans. As a remedy for pain conium is fairly efficient, but it takes fair-sized doses to accomplish results. As the terminals of the sensory and motor nerves are directly affected by the drug, it is best adapted to peripheral pain with excessive mobility. Thus it relieves spasmodic neuralgia, neuralgia from carious teeth, ovarian neuralgia, and gastralgia. In gastric ulcer it is quite efficient and safe, while for relief of pain and to give rest it is a most important drug in gastric carcinoma. If there is much destruction of tissues it is less effective, but tends to keep the surrounding part obtunded and muscularly quiet, notwithstanding the statement that it has no control over involuntary musculature. In the intestines, however, it does not seem to lessen peristalsis, and is therefore not constipating, like opium and morphine. Conium has been used for so-called chronic rheumatism, especially in the aged, who complain of muscular soreness and joint pains, with loss of sleep. Given within bounds it may relieve and can do no harm. Sometimes it relieves pruritus, especially the senile form so distressing to old people and preventing rest and sleep. Conium sometimes reduces glandular swellings. It frequently causes the disappearance of nodular masses in the axillary and mammary glands. By some it has been assumed that these are carcinomatous. There is no evidence of it having been of any service in dissipating ulcerating growths of the breast; therefore it is safe to assume that such nodules as are influenced by conium are probably not cancerous, but more than likely of a strumous character. At any rate we are not justified in delaying necessary measures by a long course of conium medication with uncertain prospects of relief in undoubted scirrhus of the breast. It may, however, be applied and be given to relieve pain even when a cure is not possible. It relieves the pain of swollen mammae during the menstrual periods a1
The full grown fruit, gathered green, of Conium maculatum, Linné (Nat. Ord. Umbelliferae). Europe and Asia; naturalized in the United States. Common Names: Hemlock, Poison Hemlock, Spotted Hemlock. Principal Constituents.-Five alkaloids of which the intensely poisonous liquid coniine (C8H17N) is most important; the others are: conhydrine (C8H17NO), pseudoconhydrine (C8H17NO), methyl-coniine (C9H19N), and ethyl-piperidine (C7H15N). Preparation.Specific Medicine Conium. 1/30 to 3 drops. Specific Indications.Nervous excitation and excessive motility, with or without pain; neuralgic pain; pain in the aged, and when there are cacoplastic deposits; gastric pain; nervousness and restlessness; mild maniacal excitement; persistent spasmodic or hacking cough; enfeebled state of the sexual organs, with late and scanty menstruation. Action and Toxicology.Conium does not affect the intellectual portion of the brain; and it acts but feebly on the spinal cord. It does, however, powerfully depress the peripheral motor endings, and in excessive amounts, the sensory terminals. Only very large doses affect the circulation and the respiration, when blood pressure falls and respiration becomes paralyzed. The latter is the cause of death by conium and is due to the combined results of depression of the respiratory center in the medulla and the nervomuscular paralysis of the muscles of respiration. Involuntary muscles are not affected by conium, nor is the heart-muscle or nerves appreciably affected. Full doses of conium produce dryness of the throat and thirst, nausea, dizziness, sinking at the stomach, numbness, muscular relaxation, and depression of the circulation. Toxic amounts cause staggering gait, muscular heaviness and prostration, with failure of locomotion, ascending paralysis, difficult and labored articulation, dyspnea, dilated pupils, palpebral ptosis, and convulsions terminating in death. In rare instances coma ensues, but usually consciousness and the intellect remained unimpaired until death. The most marked symptoms of poisoning are the staggering gait, drooping eyelids, and ascending muscular prostration. In poisoning by conium the emetic may be used, but it is preferable to repeatedly wash out the stomach by means of the stomach pump. Artificial respiration and heat are to be used, and strychnine, atropine and digitalis, as well as the diffusible stimulants, to sustain respiration and the circulation. Therapy.External. Locally applied extract of conium, or the powdered drug, relieves the pain of cancerous growths and ulcers. Locke advised, Rx. English Extract of Conium, 2 drachms; Petrolatum, 6 ounces. Mix. Apply locally. Internal. Conium is a remedy for excessive motility and for pain. It also favors sleep, not because it is a hypnotic like opium, but because it relieves pain when that is the cause of the sleeplessness, or when due to an excitable action of the heart. It is also a remedy for the restlessness, with or without pain, associated with reproductive weakness, or due to sexual excesses. With this is a state of apathy, frequently frigidity in the female, and imperfect menstruation and leucorrheal discharges. The mentality is disturbed, often to the verge of mania. In such mild forms of nervous unrest and excitability small doses of conium will render good service. Chorea is one of the incoordinate disorders that is sometimes relieved by conium, but not all cases respond to it. It has been advised in tetanus, but is insufficient except in doses which would be equally as dangerous as the disorder itself . It is better adapted to control the excessive movements of hysteria and mania, but in the former having little effect upon the psychic phase of the disorder. It has been used in teething, when twitching of the muscles is present, in laryngismus stridulus, also in whoopingcough, but we have safer and more satisfactory remedies for these affections. Some cases of epilepsy due to masturbation have been relieved by conium, and it lessens the movements of paralysis agitans. As a remedy for pain conium is fairly efficient, but it takes fair-sized doses to accomplish results. As the terminals of the sensory and motor nerves are directly affected by the drug, it is best adapted to peripheral pain with excessive mobility. Thus it relieves spasmodic neuralgia, neuralgia from carious teeth, ovarian neuralgia, and gastralgia. In gastric ulcer it is quite efficient and safe, while for relief of pain and to give rest it is a most important drug in gastric carcinoma. If there is much destruction of tissues it is less effective, but tends to keep the surrounding part obtunded and muscularly quiet, notwithstanding the statement that it has no control over involuntary musculature. In the intestines, however, it does not seem to lessen peristalsis, and is therefore not constipating, like opium and morphine. Conium has been used for so-called chronic rheumatism, especially in the aged, who complain of muscular soreness and joint pains, with loss of sleep. Given within bounds it may relieve and can do no harm. Sometimes it relieves pruritus, especially the senile form so distressing to old people and preventing rest and sleep. Conium sometimes reduces glandular swellings. It frequently causes the disappearance of nodular masses in the axillary and mammary glands. By some it has been assumed that these are carcinomatous. There is no evidence of it having been of any service in dissipating ulcerating growths of the breast; therefore it is safe to assume that such nodules as are influenced by conium are probably not cancerous, but more than likely of a strumous character. At any rate we are not justified in delaying necessary measures by a long course of conium medication with uncertain prospects of relief in undoubted scirrhus of the breast. It may, however, be applied and be given to relieve pain even when a cure is not possible. It relieves the pain of swollen mammae during the menstrual periods a1
CONVALLARIACONVA
The rhizome and rootlets of Convallaria majalis, Linné (Nat. Ord. Liliaceae.) Common Name: Lily of the Valley. Principal Constituents.Two glucosides: convallamarin (C23H44O12), a bitter, crystalline powder, and convallarin (C34H62O11), the acrid principle. Preparation.Specific Medicine Convallaria. Dose, 1 to 10 drops. Specific Indications.Cardiac irregularities due to mechanical impediments; mitral insufficiency; feeble circulation and low arterial tension; dropsy of cardiac origin; palpitation and vehement heart action, with arrythmic movements, dyspnea, and diminished arterial pressure; feeble, quickened pulse, with capillary obstruction. Action and Therapy.In its effects upon the human circulation convallaria closely resembles that of its more powerful congener, digitalis, without, however, causing the unpleasant disturbances occasioned by that drug. Unlike digitalis it is not cumulative, nor is it distinctly poisonous. Moreover, it has a laxative action, and like digitalis, increases diuresis secondarily, by its effects upon blood pressure. Like digitalis, convallaria may be used where there is feeble circulation and low blood-pressure. While digitalis is the more often indicated, sometimes convallaria is more effective on account of the disturbing extravascular effects of the former. Convallaria appears to act best in those cases of circulatory failure in which there is imperfect circulation within the heart itself and probably due to capillary resistance or peripheral circulatory enfeeblement. By relieving the latter the cardiac embarrassment is removed. Convallaria slows the pulse and gives increased force to the heart-beat. It undoubtedly tones the heart muscle and strengthens its action. By the double action of augmenting the power of the heart and the tone of the vessels, as well as by its secondary effect of increasing renal activity, it acts extremely well in dropsy of cardiac origin. Palpitation and irregular heart movements, dyspnoea, diminished urinary secretion, albumen, hepatic fullness and engorgement, and edema-symptoms of this form of cardiac insufficiency, gradually disappear under small and continued doses of this drug. Moderate doses calm cardiac excitement, such as is due to overexertion and the excessive use of tobacco. Cardiac arrythmia and hurried action of the heart are especially benefited by it. The heart irregularities corrected by convallaria are not those due to organic degeneration, but rather those of an obstructive character, due to mechanical causes, as when the mitral valves are involved. Thus it is especially valuable in mitral insufficiency, with its attendant dyspnea and palpitation. When acting favorably the heart action becomes slower and stronger, normal rhythm is established, arterial pressure increased, respiration deepened, and the sense of suffocation, with the distressing and painful desire for air, is dispelled. A drug that will bring about these results and do it kindly is an ideal heart stimulant, and such is convallaria. Convallaria relieves the sense of praecordial oppression and faintness that so frequently follows prostrating diseases. Not alone is it a heart tonic, but a gastric tonic as well. Therefore it is indicated by the cardiac debility that follows typhoid fever, la grippe, acute articular rheumatism, and other heartenfeebling diseases. When a heart stimulant is needed during acute rheumatism, convallaria is, as a rule, preferable to digitalis, and it is often valuable in the early stages of rheumatic carditis and endocarditis, using it in fractional doses. Convallaria is of less service in stenosis of the aorta than in mitral disorders.1
The rhizome and rootlets of Convallaria majalis, Linné (Nat. Ord. Liliaceae.) Common Name: Lily of the Valley. Principal Constituents.Two glucosides: convallamarin (C23H44O12), a bitter, crystalline powder, and convallarin (C34H62O11), the acrid principle. Preparation.Specific Medicine Convallaria. Dose, 1 to 10 drops. Specific Indications.Cardiac irregularities due to mechanical impediments; mitral insufficiency; feeble circulation and low arterial tension; dropsy of cardiac origin; palpitation and vehement heart action, with arrythmic movements, dyspnea, and diminished arterial pressure; feeble, quickened pulse, with capillary obstruction. Action and Therapy.In its effects upon the human circulation convallaria closely resembles that of its more powerful congener, digitalis, without, however, causing the unpleasant disturbances occasioned by that drug. Unlike digitalis it is not cumulative, nor is it distinctly poisonous. Moreover, it has a laxative action, and like digitalis, increases diuresis secondarily, by its effects upon blood pressure. Like digitalis, convallaria may be used where there is feeble circulation and low blood-pressure. While digitalis is the more often indicated, sometimes convallaria is more effective on account of the disturbing extravascular effects of the former. Convallaria appears to act best in those cases of circulatory failure in which there is imperfect circulation within the heart itself and probably due to capillary resistance or peripheral circulatory enfeeblement. By relieving the latter the cardiac embarrassment is removed. Convallaria slows the pulse and gives increased force to the heart-beat. It undoubtedly tones the heart muscle and strengthens its action. By the double action of augmenting the power of the heart and the tone of the vessels, as well as by its secondary effect of increasing renal activity, it acts extremely well in dropsy of cardiac origin. Palpitation and irregular heart movements, dyspnoea, diminished urinary secretion, albumen, hepatic fullness and engorgement, and edema-symptoms of this form of cardiac insufficiency, gradually disappear under small and continued doses of this drug. Moderate doses calm cardiac excitement, such as is due to overexertion and the excessive use of tobacco. Cardiac arrythmia and hurried action of the heart are especially benefited by it. The heart irregularities corrected by convallaria are not those due to organic degeneration, but rather those of an obstructive character, due to mechanical causes, as when the mitral valves are involved. Thus it is especially valuable in mitral insufficiency, with its attendant dyspnea and palpitation. When acting favorably the heart action becomes slower and stronger, normal rhythm is established, arterial pressure increased, respiration deepened, and the sense of suffocation, with the distressing and painful desire for air, is dispelled. A drug that will bring about these results and do it kindly is an ideal heart stimulant, and such is convallaria. Convallaria relieves the sense of praecordial oppression and faintness that so frequently follows prostrating diseases. Not alone is it a heart tonic, but a gastric tonic as well. Therefore it is indicated by the cardiac debility that follows typhoid fever, la grippe, acute articular rheumatism, and other heartenfeebling diseases. When a heart stimulant is needed during acute rheumatism, convallaria is, as a rule, preferable to digitalis, and it is often valuable in the early stages of rheumatic carditis and endocarditis, using it in fractional doses. Convallaria is of less service in stenosis of the aorta than in mitral disorders.1
DIGITALIS
The leaves of Digitalis purpurea, Linné (Nat. Ord. Scrophulariaceae), carefully dried and preserved away from light, in close containers. Europe; cultivated in Europe and to some extent in America. Dose, 1 to 2 grains. Common Names: Foxglove, Purple Foxglove. Principal Constituents.The glucosides digitoxin (very toxic and cumulative), digitalin, digitalein, digitonin, and digitin (inert); digitalic and antirrhinic acids, volatile oil, etc. There are no positively determined alkaloids in digitalis. Preparations.1. Specific Medicine Digitalis. Dose, 1/5 to 1 drop. 2. Infusum Digitalis. Infusion of Digitalis. (A cinnamon-flavored, 1 1/2 per cent, infusion). Dose, 1 to 2 fluidrachms. 3. Tinctura Digitalis, Tincture of Digitalis (10 per cent of drug). Dose, 1 to 10 drops.Doses of Digitalis Glucosides:Digitoxin, 1/300 to 1/64 grain; digitalin (crystallizable), 1/300 to 1/100 grain, (amorphous and German), 1/100 to 1/30 grain, (digitalin is so variable that it should not be used; it may be very actively poisonous, or may be nearly inert); digitalein (water soluble), 1/200 to 1/100 grain. Specific Indications.Weak, rapid, and irregular heart action, with low arterial tension; broken compensation; weak, rapid, flaccid pulse; weak heart sounds; dusky countenance, with dyspnoea, cough, jugular fullness, and weak cardiac action; edema, anasarca, or ascites with scanty supply of dark-colored urine, with weak heart action; renal congestion; irritable heart with weak action; heart made to beat rapidly but feebly by slight excitement; continuous labored breathing with weak pulsation; renal and cardiac dropsy; desquamative nephritis, with weak heart; capillary hemorrhage; poisoning by aconite, muscarine, or the nitrites. Action.The dominant action of digitalis is upon the circulation, but it has no perceptible effect upon the blood. Full or even moderate doses may excite nausea and vomiting, and a greenish or yellowish diarrhoea. These effects are preceded by considerable prostration. If the stomach is already irritated, or there is gastro-intestinal irritation, these disturbances are more certain to occur. Only in toxic amounts does digitalis affect the respiration, first slowing and deepening, and finally accelerating the breathing. Neither do other than poisonous doses impress the nervous system, and then it lessens reflex activity through stimulation of Setschenow's center of inhibition in the medulla, and is followed by depression of the spinal cord and motor nerve trunks and by eventual paralysis of the muscles. These extreme effects on the nervous and respiratory systems have only been noted in animals; apparently they do not take place in man. Therapeutic doses, however, stimulate the cardiac inhibitory and vasomotor centers of the medulla. Digitalis, in moderate doses, has little or no effect upon temperature, but poisonous doses lower it. When fever is present, however, it actively reduces the body heat, yet it is not a good nor safe antipyretic. It has been conclusively proved that high temperature prevents digitalis from slowing the pulse. In moderate doses digitalis slows the heart-action, increases the force of the pulse, and from these effects chiefly, raises blood-pressure. The diastole is prolonged and the systole is increased in vigor. The result of the stronger systole is to reduce the number of pulsations. Not only does the retarded diastole give more rest to the heart, but it is followed by a better contraction of the heart-muscle and some constriction of the arterioles, so that the blood-current is reduced in size and the quantity of blood sent out through the systemic arteries is lessened. The narrowed arterial resistance and the stronger systolic contraction are the chief causes of increased blood-pressure, though to a limited extent, especially when larger doses are given, the vaso-motor apparatus exerts some control, as does also a direct impression of the drug upon the walls of the vessels. All of the above effects are those of stimulation, never of depression, and digitalis, in such doses, is therefore a heart stimulant and heart tonic. When carried to extremes the tonic effects may be overreached, and then the condition verges into exhaustion from over-stimulation of the heartmuscle and from a failure of the normal impulse conduction from auricle to ventricle. This is particularly evident when a person taking full and repeated doses of digitalis suddenly collapses when raised from a recumbent to a sitting posture. So powerful is the effect upon the heart-muscle that tetanic contraction may occur and prevent a passage of blood through the heart, the tonic spasm resulting in syncope; and the exhaustion and syncope are so great as sometimes to prove fatal. The effects of digitalis may be conveniently studied under three heads, or stages, representing, however, but continuous action under normal and increased dosage rather than three actually separate conditions: (1) The therapeutic; (2) the toxic; and (3) the extreme toxic or lethal stages. (1) In the therapeutic stage the rhythm is slowed and the ventricles empty themselves more perfectly and by their increased force pump more blood into the vessels. The diastole being greatly prolonged and the force of the systole increased, there is produced a larger though less frequent pulse wave. The auricles are less affected than the ventricles, but on the whole the heart does more work, and were it not for the increased resistance in the vessels and lessened number of contractions more blood would be propelled into the body. As it is, the current is carried more completely to the extremities of the capillaries, and altogether the circulation is improved. (2) The second stage is sometimes absent. It takes place when the drug is given in overdose or for a continuous period without rest. The pulse becomes very slow and irregular. The ventricle dilates more completely, thus prolonging the diastole; the systole becomes erratic in force,1
The leaves of Digitalis purpurea, Linné (Nat. Ord. Scrophulariaceae), carefully dried and preserved away from light, in close containers. Europe; cultivated in Europe and to some extent in America. Dose, 1 to 2 grains. Common Names: Foxglove, Purple Foxglove. Principal Constituents.The glucosides digitoxin (very toxic and cumulative), digitalin, digitalein, digitonin, and digitin (inert); digitalic and antirrhinic acids, volatile oil, etc. There are no positively determined alkaloids in digitalis. Preparations.1. Specific Medicine Digitalis. Dose, 1/5 to 1 drop. 2. Infusum Digitalis. Infusion of Digitalis. (A cinnamon-flavored, 1 1/2 per cent, infusion). Dose, 1 to 2 fluidrachms. 3. Tinctura Digitalis, Tincture of Digitalis (10 per cent of drug). Dose, 1 to 10 drops.Doses of Digitalis Glucosides:Digitoxin, 1/300 to 1/64 grain; digitalin (crystallizable), 1/300 to 1/100 grain, (amorphous and German), 1/100 to 1/30 grain, (digitalin is so variable that it should not be used; it may be very actively poisonous, or may be nearly inert); digitalein (water soluble), 1/200 to 1/100 grain. Specific Indications.Weak, rapid, and irregular heart action, with low arterial tension; broken compensation; weak, rapid, flaccid pulse; weak heart sounds; dusky countenance, with dyspnoea, cough, jugular fullness, and weak cardiac action; edema, anasarca, or ascites with scanty supply of dark-colored urine, with weak heart action; renal congestion; irritable heart with weak action; heart made to beat rapidly but feebly by slight excitement; continuous labored breathing with weak pulsation; renal and cardiac dropsy; desquamative nephritis, with weak heart; capillary hemorrhage; poisoning by aconite, muscarine, or the nitrites. Action.The dominant action of digitalis is upon the circulation, but it has no perceptible effect upon the blood. Full or even moderate doses may excite nausea and vomiting, and a greenish or yellowish diarrhoea. These effects are preceded by considerable prostration. If the stomach is already irritated, or there is gastro-intestinal irritation, these disturbances are more certain to occur. Only in toxic amounts does digitalis affect the respiration, first slowing and deepening, and finally accelerating the breathing. Neither do other than poisonous doses impress the nervous system, and then it lessens reflex activity through stimulation of Setschenow's center of inhibition in the medulla, and is followed by depression of the spinal cord and motor nerve trunks and by eventual paralysis of the muscles. These extreme effects on the nervous and respiratory systems have only been noted in animals; apparently they do not take place in man. Therapeutic doses, however, stimulate the cardiac inhibitory and vasomotor centers of the medulla. Digitalis, in moderate doses, has little or no effect upon temperature, but poisonous doses lower it. When fever is present, however, it actively reduces the body heat, yet it is not a good nor safe antipyretic. It has been conclusively proved that high temperature prevents digitalis from slowing the pulse. In moderate doses digitalis slows the heart-action, increases the force of the pulse, and from these effects chiefly, raises blood-pressure. The diastole is prolonged and the systole is increased in vigor. The result of the stronger systole is to reduce the number of pulsations. Not only does the retarded diastole give more rest to the heart, but it is followed by a better contraction of the heart-muscle and some constriction of the arterioles, so that the blood-current is reduced in size and the quantity of blood sent out through the systemic arteries is lessened. The narrowed arterial resistance and the stronger systolic contraction are the chief causes of increased blood-pressure, though to a limited extent, especially when larger doses are given, the vaso-motor apparatus exerts some control, as does also a direct impression of the drug upon the walls of the vessels. All of the above effects are those of stimulation, never of depression, and digitalis, in such doses, is therefore a heart stimulant and heart tonic. When carried to extremes the tonic effects may be overreached, and then the condition verges into exhaustion from over-stimulation of the heartmuscle and from a failure of the normal impulse conduction from auricle to ventricle. This is particularly evident when a person taking full and repeated doses of digitalis suddenly collapses when raised from a recumbent to a sitting posture. So powerful is the effect upon the heart-muscle that tetanic contraction may occur and prevent a passage of blood through the heart, the tonic spasm resulting in syncope; and the exhaustion and syncope are so great as sometimes to prove fatal. The effects of digitalis may be conveniently studied under three heads, or stages, representing, however, but continuous action under normal and increased dosage rather than three actually separate conditions: (1) The therapeutic; (2) the toxic; and (3) the extreme toxic or lethal stages. (1) In the therapeutic stage the rhythm is slowed and the ventricles empty themselves more perfectly and by their increased force pump more blood into the vessels. The diastole being greatly prolonged and the force of the systole increased, there is produced a larger though less frequent pulse wave. The auricles are less affected than the ventricles, but on the whole the heart does more work, and were it not for the increased resistance in the vessels and lessened number of contractions more blood would be propelled into the body. As it is, the current is carried more completely to the extremities of the capillaries, and altogether the circulation is improved. (2) The second stage is sometimes absent. It takes place when the drug is given in overdose or for a continuous period without rest. The pulse becomes very slow and irregular. The ventricle dilates more completely, thus prolonging the diastole; the systole becomes erratic in force,1
ELATERIUM
The feculence of the juice of the fruit of Ecballium Elaterium (Linné), A. Richard. (Nat. Ord. Cucurbitaceae.) A trailing vine of southern Europe. Common Names (of fruit): Squirting Cucumber, Wild Cucumber, Wild Balsam Apple. Description.Light, brittle, flat flakes, pale-gray with a greenish or yellowish tinge, a tea-like odor, and an intensely bitter taste. Principal Constituent.The neutral purgative principle elaterin (C20H28O5) present to the extent of 20 to 25 per cent. Preparation.Specific Medicine Elaterium. Dose, 1 to 20 drops. Derivative.Elaterinum, Elaterin. (Odorless, very bitter, and slightly acrid, white scales or crystals; permanent in the air. Very soluble in chloroform; sparingly in alcohol, and almost insoluble in water.) Dose, 1/40 to 1/8 grain. Of the Trituratio Elaterini (elaterin, 1; sugar of milk, 9), 1/4 to 1/2 grain. Specific Indications.Chronic cystitis with pain in the neck of bladder, the urine passes in a torrent, and after micturition there is violent cramplike aching extending from the bladder into the pelvis and thighs; deep soreness or tenderness in the bladder, perineum, or throughout the pelvis, with tenesmic voiding of mucus or muco-pusladen urine; dropsies of plethora; cerebral congestion; pulmonary edema. Action and Therapy.Elaterium is the most powerful and the best of the hydragogue cathartics. As such it is indicated only in individuals strong enough to stand depletion, and is always contraindicated in the weak and feeble. Overdoses-even a few grains-may produce a diffuse gastro-enteritis, with violent vomiting, cramps, and watery purgation. In medium doses only copious watery stools are produced, but with considerable depression. The treatment for excessive action of elaterium is that for gastro-enteritis in general. In medium doses elaterium has been, and is still to a lesser extent, used as a dehydrating cathartic in chronic dropsies of hepatic or abdominal origin, and in chronic nephritis. When the liver is involved, with congestion or torpor, it may be given with podophyllin; if there are heart complications, with digitalis. It is quite certain to reduce the ascites; but when the latter is dependent on destruction of tissue, it does not, of course, cure the disease, of which the dropsy is but a symptom. It is often useful in dropsy after scarlet fever, if the patient is not greatly exhausted; and it is more especially indicated when uremic convulsions threaten or are present. Elaterium is a useful purgative when a revulsive is needed in cerebral congestion. The small dose of elaterium is preferred for other specific purposes. Elaterium is the remedy for chronic inflammation of the bladder, as first announced by King. When indicated the urine rushes from the urethra as in a torrent and is accompanied by constant pain radiating from the neck of the bladder to the surrounding tissues, and micturition is followed by violent pelvic and femoral cramps. This condition is frequently associated with general pelvic dragging and tenderness, and the urine is characteristic of chronic subacute inflammation-ropy with mucus or mucopus. The dose should be small enough not to provoke emesis or catharsis. The usual prescription is: Rx Specific Medicine Elaterium, 10-20 drops; Water, enough to make 4 fluidounces. Mix. Sig.: One teaspoonful 3 or 4 times a day. For hydragogue purposes Elaterin is preferred by some physicians, though elaterium, notwithstanding its impurities, seems to be more generally efficient than its derivative.1
The feculence of the juice of the fruit of Ecballium Elaterium (Linné), A. Richard. (Nat. Ord. Cucurbitaceae.) A trailing vine of southern Europe. Common Names (of fruit): Squirting Cucumber, Wild Cucumber, Wild Balsam Apple. Description.Light, brittle, flat flakes, pale-gray with a greenish or yellowish tinge, a tea-like odor, and an intensely bitter taste. Principal Constituent.The neutral purgative principle elaterin (C20H28O5) present to the extent of 20 to 25 per cent. Preparation.Specific Medicine Elaterium. Dose, 1 to 20 drops. Derivative.Elaterinum, Elaterin. (Odorless, very bitter, and slightly acrid, white scales or crystals; permanent in the air. Very soluble in chloroform; sparingly in alcohol, and almost insoluble in water.) Dose, 1/40 to 1/8 grain. Of the Trituratio Elaterini (elaterin, 1; sugar of milk, 9), 1/4 to 1/2 grain. Specific Indications.Chronic cystitis with pain in the neck of bladder, the urine passes in a torrent, and after micturition there is violent cramplike aching extending from the bladder into the pelvis and thighs; deep soreness or tenderness in the bladder, perineum, or throughout the pelvis, with tenesmic voiding of mucus or muco-pusladen urine; dropsies of plethora; cerebral congestion; pulmonary edema. Action and Therapy.Elaterium is the most powerful and the best of the hydragogue cathartics. As such it is indicated only in individuals strong enough to stand depletion, and is always contraindicated in the weak and feeble. Overdoses-even a few grains-may produce a diffuse gastro-enteritis, with violent vomiting, cramps, and watery purgation. In medium doses only copious watery stools are produced, but with considerable depression. The treatment for excessive action of elaterium is that for gastro-enteritis in general. In medium doses elaterium has been, and is still to a lesser extent, used as a dehydrating cathartic in chronic dropsies of hepatic or abdominal origin, and in chronic nephritis. When the liver is involved, with congestion or torpor, it may be given with podophyllin; if there are heart complications, with digitalis. It is quite certain to reduce the ascites; but when the latter is dependent on destruction of tissue, it does not, of course, cure the disease, of which the dropsy is but a symptom. It is often useful in dropsy after scarlet fever, if the patient is not greatly exhausted; and it is more especially indicated when uremic convulsions threaten or are present. Elaterium is a useful purgative when a revulsive is needed in cerebral congestion. The small dose of elaterium is preferred for other specific purposes. Elaterium is the remedy for chronic inflammation of the bladder, as first announced by King. When indicated the urine rushes from the urethra as in a torrent and is accompanied by constant pain radiating from the neck of the bladder to the surrounding tissues, and micturition is followed by violent pelvic and femoral cramps. This condition is frequently associated with general pelvic dragging and tenderness, and the urine is characteristic of chronic subacute inflammation-ropy with mucus or mucopus. The dose should be small enough not to provoke emesis or catharsis. The usual prescription is: Rx Specific Medicine Elaterium, 10-20 drops; Water, enough to make 4 fluidounces. Mix. Sig.: One teaspoonful 3 or 4 times a day. For hydragogue purposes Elaterin is preferred by some physicians, though elaterium, notwithstanding its impurities, seems to be more generally efficient than its derivative.1
GAULTHERIA
The leaves of Gaultheria procumbens, Linné (Nat. Ord. Ericaceae). Damp woods and sandy soils of eastern third of the United States. Common Names: Wintergreen, Teaberry, Mountain Tea, Boxberry. Principal Constituents.An aromatic volatile oil (Oleum Gaultheriae); arbutin, ericolin and urson. Preparations.1. Oleum Gaultheriae, Oil of Wintergreen. True Oil of Wintergreen; composed of about 96 per cent of methyl salicylate. Dose, 5 to 15 drops. 2. Specific Medicine Gaultheria. Dose, 5 to 20 drops. 3. Spiritus Gaultheriae, Spirit of Gaultheria (Essence of Wintergreen5 per cent of oil in alcohol). Chiefly a flavor essence. Related Oil.Methylis Salicylas, Methyl Salicylate or Artificial Oil of Wintergreen. This is prepared synthetically and sold under the name of Oil of Wintergreen. Its source must be stated on the label. It ranges from colorless to yellowish or reddish and has the odor and taste of wintergreen. Dose, 5 to 15 drops. Specific Indications.Irritation of the bladder and prostate gland; undue sexual excitement, and early stage of renal inflammation. Action.Oil of wintergreen has identically the same physiological action as salicylic acid except that in poisonous doses it is more certain to produce coma. The symptoms of toxic doses are drowsiness, cerebral congestion with throbbing of the carotids, delirium, contracted or dilated pupils, visual disturbances, tinnitus aurium, paresis, somnolence, and coma preceding death. Autopsy reveals congestion of the stomach, duodenum, and the kidneys. Therapy.External. Oil of wintergreen in full strength may be applied to carious teeth to relieve toothache. In full strength, or in suitable dilution with olive oil or cottonseed oil, it provides a good painrelieving application for acute articular and chronic rheumatism and in gonorrheal arthritis. If used very strong the skin may subsequently exfoliate. Applied to denuded surfaces it is readily absorbed and may produce toxic effects. Embrocations containing oil of wintergreen are valuable for local inflammatory swellings, neuralgic pain, pleurodynia, myalgia, itching, and swelling and stiffness of the joints. The following are a few of many such liniments: (1) Oil of Gaultheria, 3 fluidrachms; Oil of Olive, enough to make 6 fluidounces. Mix. (2) Oil of Gaultheria, 3 drachms; Salicylic Acid, 20 grains; Alcohol, 2 fluidounces; Oil of Olive, enough to make 6 fluidounces; Mix. Shake when used. Especially useful upon rheumatic joints. (3) Oil of Gaultheria, 3 fluidrachms; Chloroform Liniment and Soap Liniment, 2 fluidounces each. Mix. Shake when used. For painful surfaces. (4) Oil of Gaultheria, 2 fluidounces; Asepsin, 15 grains; Echafolta and Alcohol, 2 1/2 fluidounces each. Mix. Valuable for application to cuts, bruises, and diluted with water as a mouth wash. Internal. Specific Medicine Gaultheria, or an infusion (Leaves, 1 ounce to Water, 16 fluidounces), has a specific action upon the urino-genital tract, relieving irritation and subacute inflammation. This action is especially exerted upon the neck of the bladder and in the prostatic urethra. It does not greatly increase the secretion of urine, but renders its voiding easier by alleviating the sphincteric irritation. It is, therefore, a remedy for dysuria. In incipient renal inflammation it sometimes does good, and in acute tubal nephritis it is asserted to have given benefit even where blood and tube casts are passed. Considerable good has been accomplished with it when spermatorrhea and sexual excitement are caused by urethral irritability and prostatic fullness. The specific medicine may be administered in 5 to 15 drops doses in water 3 or 4 times a day. Some physicians have advised both gaultheria and its oil for the relief of hepatic congestion and in sluggish vascularity and engorgement of the intestinal glands, as well as to relieve hemorrhoids by overcoming congestion of the portal vessels. Oil of gaultheria has aromatic and antiseptic properties. It consists most largely of methyl salicylate, over 90 parts at least, and is therefore analogous to salicylic acid and the salicylates in its effects. Large doses depress the heart just as the salicylates do; large doses also cause nausea and vomiting. Used within bounds, short of sufficient to induce gastric derangement, it is very useful where an anti-rheumatic is demanded and in cystic disorders with putrescent urine. Too long continued, however, it may induce renal irritation, and this must be carefully guarded against. Urine that was ammoniacal and putrescent a few hours after passage has been followed, after the administration of twenty drops of the oil, by an output that remained free from putrefaction for twelve days. One part of the oil in about two hundred of urine has preserved the latter from change for eighteen days. Hence the value of this oil in cystitis with putrescent urine. While few agents should be administered with digitalis, oil of wintergreen is a grateful adjuvant and does not impair the usefulness of the foxglove. If for any reason sodium salicylate disagrees with rheumatic patients, oil of wintergreen, which is less likely to contain deleterious by-products, may be given. It is useful in all types of acute rheumatism in which salicylic acid or the salicylates are effective. Those most benefited are the acute inflammatory rheumatism and so-called gonorrheal rheumatism, a specific gonorrheal arthritic infection. Small doses have relieved facial neuralgia and tic douloureux; and sometimes it exerts a soothing and antiseptic effect in acute gonorrhea. The oil may be administered in olive oil or in the form of the spirit (essence) mixed with sweetened water. The essence is of service in dry, persistent bronchial cough, and the specific medicine in cough with considerable bronchial secretion. It is also useful in the colic of infants. Gaultheria is an agent of special value as a flavoring agent and preservative for water-dispensed medicines in the summer season. Fo1
The leaves of Gaultheria procumbens, Linné (Nat. Ord. Ericaceae). Damp woods and sandy soils of eastern third of the United States. Common Names: Wintergreen, Teaberry, Mountain Tea, Boxberry. Principal Constituents.An aromatic volatile oil (Oleum Gaultheriae); arbutin, ericolin and urson. Preparations.1. Oleum Gaultheriae, Oil of Wintergreen. True Oil of Wintergreen; composed of about 96 per cent of methyl salicylate. Dose, 5 to 15 drops. 2. Specific Medicine Gaultheria. Dose, 5 to 20 drops. 3. Spiritus Gaultheriae, Spirit of Gaultheria (Essence of Wintergreen5 per cent of oil in alcohol). Chiefly a flavor essence. Related Oil.Methylis Salicylas, Methyl Salicylate or Artificial Oil of Wintergreen. This is prepared synthetically and sold under the name of Oil of Wintergreen. Its source must be stated on the label. It ranges from colorless to yellowish or reddish and has the odor and taste of wintergreen. Dose, 5 to 15 drops. Specific Indications.Irritation of the bladder and prostate gland; undue sexual excitement, and early stage of renal inflammation. Action.Oil of wintergreen has identically the same physiological action as salicylic acid except that in poisonous doses it is more certain to produce coma. The symptoms of toxic doses are drowsiness, cerebral congestion with throbbing of the carotids, delirium, contracted or dilated pupils, visual disturbances, tinnitus aurium, paresis, somnolence, and coma preceding death. Autopsy reveals congestion of the stomach, duodenum, and the kidneys. Therapy.External. Oil of wintergreen in full strength may be applied to carious teeth to relieve toothache. In full strength, or in suitable dilution with olive oil or cottonseed oil, it provides a good painrelieving application for acute articular and chronic rheumatism and in gonorrheal arthritis. If used very strong the skin may subsequently exfoliate. Applied to denuded surfaces it is readily absorbed and may produce toxic effects. Embrocations containing oil of wintergreen are valuable for local inflammatory swellings, neuralgic pain, pleurodynia, myalgia, itching, and swelling and stiffness of the joints. The following are a few of many such liniments: (1) Oil of Gaultheria, 3 fluidrachms; Oil of Olive, enough to make 6 fluidounces. Mix. (2) Oil of Gaultheria, 3 drachms; Salicylic Acid, 20 grains; Alcohol, 2 fluidounces; Oil of Olive, enough to make 6 fluidounces; Mix. Shake when used. Especially useful upon rheumatic joints. (3) Oil of Gaultheria, 3 fluidrachms; Chloroform Liniment and Soap Liniment, 2 fluidounces each. Mix. Shake when used. For painful surfaces. (4) Oil of Gaultheria, 2 fluidounces; Asepsin, 15 grains; Echafolta and Alcohol, 2 1/2 fluidounces each. Mix. Valuable for application to cuts, bruises, and diluted with water as a mouth wash. Internal. Specific Medicine Gaultheria, or an infusion (Leaves, 1 ounce to Water, 16 fluidounces), has a specific action upon the urino-genital tract, relieving irritation and subacute inflammation. This action is especially exerted upon the neck of the bladder and in the prostatic urethra. It does not greatly increase the secretion of urine, but renders its voiding easier by alleviating the sphincteric irritation. It is, therefore, a remedy for dysuria. In incipient renal inflammation it sometimes does good, and in acute tubal nephritis it is asserted to have given benefit even where blood and tube casts are passed. Considerable good has been accomplished with it when spermatorrhea and sexual excitement are caused by urethral irritability and prostatic fullness. The specific medicine may be administered in 5 to 15 drops doses in water 3 or 4 times a day. Some physicians have advised both gaultheria and its oil for the relief of hepatic congestion and in sluggish vascularity and engorgement of the intestinal glands, as well as to relieve hemorrhoids by overcoming congestion of the portal vessels. Oil of gaultheria has aromatic and antiseptic properties. It consists most largely of methyl salicylate, over 90 parts at least, and is therefore analogous to salicylic acid and the salicylates in its effects. Large doses depress the heart just as the salicylates do; large doses also cause nausea and vomiting. Used within bounds, short of sufficient to induce gastric derangement, it is very useful where an anti-rheumatic is demanded and in cystic disorders with putrescent urine. Too long continued, however, it may induce renal irritation, and this must be carefully guarded against. Urine that was ammoniacal and putrescent a few hours after passage has been followed, after the administration of twenty drops of the oil, by an output that remained free from putrefaction for twelve days. One part of the oil in about two hundred of urine has preserved the latter from change for eighteen days. Hence the value of this oil in cystitis with putrescent urine. While few agents should be administered with digitalis, oil of wintergreen is a grateful adjuvant and does not impair the usefulness of the foxglove. If for any reason sodium salicylate disagrees with rheumatic patients, oil of wintergreen, which is less likely to contain deleterious by-products, may be given. It is useful in all types of acute rheumatism in which salicylic acid or the salicylates are effective. Those most benefited are the acute inflammatory rheumatism and so-called gonorrheal rheumatism, a specific gonorrheal arthritic infection. Small doses have relieved facial neuralgia and tic douloureux; and sometimes it exerts a soothing and antiseptic effect in acute gonorrhea. The oil may be administered in olive oil or in the form of the spirit (essence) mixed with sweetened water. The essence is of service in dry, persistent bronchial cough, and the specific medicine in cough with considerable bronchial secretion. It is also useful in the colic of infants. Gaultheria is an agent of special value as a flavoring agent and preservative for water-dispensed medicines in the summer season. Fo1
References
1) Felter, Harvey Wickes, 1922, The Eclectic Materia Medica, Pharmacology and Therapeutics, Cincinnati, Ohio.