CACTUS (Selenicereus spp.)
   The fresh, green stems and the flowers of Selenicereus grandiflorus (L.) Britt. & Rose (and other Selenicereus species—MM) (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

CYPRIPEDIUM^CYAL10
   The rhizome and rootlets of Cypripedium pubescens, Swartz; and of Cypripedium parviflorum, Salisbury. (Nat. Ord. Orchidaceae.) Rich woods of the United States. Dose, 5 to 60 grains. Common Names: (1) Ladies’ Slipper, Yellow Ladies’ Slipper, American Valerian, Yellow Mocassin Flower, Nerve Root; (2) Small-flowered Ladies’ Slipper. Principal Constituents.—A volatile oil, tannin and gallic acids, a volatile acid, resins, and inorganic salts. Preparation.—Specific Medicine Cypripedium. Dose, 5 to 60 drops. Specific Indications.—Insomnia, nervous irritability, neuralgia and delirium, all from atony; restlessness and muscular twitching, typhomania and tremors in low forms of fever; wakefulness from mental unrest; menstrual irregularities, with despondency; tendency to dementia at the climacteric; mental depression from sexual abuse. Action and Therapy.—All of the species of Cypripedium resemble valerian in their effects. They are excellent nerve stimulants for weak women and nervous children. They improve a feeble circulation and increase the innervating power of weakened nerve centers. Though comparatively feeble agents, they are nevertheless important medicines, being of that type of drugs which silently do great good without marked physiological disturbance. Cypripedium is an ideal tranquilizer for states of nervous excitability or irritability depending upon atony. It dispels gloom, induces a calm and cheerful state of mind, and by thus inducing mental tranquillity favors restful sleep. When nervous irritability is caused reflexly by pelvic disorders it is especially a useful drug. If due to organic disease it is less effectual than in merely functional disorders. We value cypripedium highly for the hypochondria of the menopause. We have been able to accomplish more with it than any drug except pulsatilla in worry, with fear of disaster or insanity, in women passing through this phase of life. It is useful in melancholia and sleeplessness due to menstrual irregularities, after prolonged and severe pain, and in those the result of nocturnal losses. It relieves the nervous unrest attending gleet, and the sexual erethism of debility. In the typhomania and tremors of low fevers it is a safe and often effectual drug, but like all others in these conditions it frequently fails to give relief. It acts well after long sieges of exhausting diseases to give nerve tone and allay the nervous manifestations of general debility. An excellent soothing syrup for irritable children, especially during dentition, was proposed by Scudder: Rx. Specific Medicine Cypripedium and Compound Tincture of Lavender, each 3 fluidrachms; Specific Medicine Lobelia, 1 fluidrachm; Simple Syrup, enough to make 3 fluidounces. Mix. Sig.: Dose, 5 to 20 drops. If nausea occurs lessen the amount of, or omit the lobelia.¹

PULSATILLA
   The recent herb of Anemone Pulsatilla, Linné, and of Anemone pratensis, Linné, collected soon after flowering (Nat. Ord. Ranunculaceae). Southern Europe and Asia. Common Names: Pasque-Flower, Passe-Flower, Meadow Anemone, Wind Flower. Principal Constituents.—A yellow, acrid oil, yielding anemone camphor, a vesicating principle easily decomposing into anemonin (C10H8O4) and isoanemonic acid. Preparation.—Specific Medicine Pulsatilla. Dose, 1/10 to 10 drops. ( The usual form of administration: Rx Specific Medicine Pulsatilla, 5-30 drops; Water, enough to make 4 fluidounces. Mix. Sig.: One teaspoonful every 2 or 3 hours.) Specific Indications.—Nervousness with despondency, sadness and disposition to weep, without being able to tell why, or to weep while asleep; unnatural fear; fear of impending danger or death; morbid mental excitation associated with physical debility; marked depression of spirits; insomnia, with nervous exhaustion; pain, with debility; headache, with nervousness, not dependent on determination of blood to the head; neuralgia in anemic nervous subjects; mental depression and gloom over reproductive wrongs and disturbances, as spermatorrhea, and tardy and insufficient menstruation (with sense of fullness and weakness in back and hips); nervous collapse, due to overwork, sexual indulgence, masturbation, or to the excessive use of tobacco; amenorrhea with chilliness and mental depression; dysmenorrhea, with gloomy mentality and chilliness; pain from exposure to winds; epiphora; styes; deep-seated heavy pain in the globe of the eye; jumping toothache from abscess near the dental pulp; stomach disorders from indulgence in pastries and fats; pasty, creamy, or white coating upon the tongue, with greasy taste; thick, bland, and inoffensive mucous discharges; alternating constipation and diarrhea, with venous congestion. Action.-Topically applied, the fresh plant of pulsatilla is irritant, and, if kept long in contact with the skin, may vesicate. When chewed, it produces a benumbing sensation and tingling formication, somewhat like that produced by aconite or prickly ash. Taken internally in overdoses, it is a gastric irritant, producing a sense of rawness, burning pain in stomach, with endeavors to vomit, all accompanied by marked prostration. A sense of constriction and tightness of the chest, with chilliness, marked weakness, and some congestion, has been produced by large doses. Full doses depress the action of the heart, lower arterial tension, and reduce temperature. Sensory and motor paralyses have followed very large doses of pulsatilla, while toxic doses may produce mydriasis, stupor, coma, and convulsions. In medicinal doses, pulsatilla increases the power and regulates the action of the heart, and gives a better character to the pulse rate, particularly slowing the irritable, rapid and feeble pulse due to nervous depression. It improves the sympathetic system and cerebral functions, and especially strengthens sympathetic innervation, this action being very marked in troubles of the reproductive organs of the male and female. Therapy.—External. The value of pulsatilla has been emphasized in “jerking” or “jumping” toothache, usually due to the formation of a pus cavity near the nerve. Full strength specific medicine pulsatilla, or diluted one-half with water, is applied besides giving the drug internally. This treatment is also commended as “especially useful in inflammations caused by dead teeth, and the inflammatory, painful, and unpleasant conditions of the pulp cavity in those in which the nerve has been destroyed.” Internal. Though not of Eclectic origin, pulsatilla is one of the most important medicines in Eclectic therapy. For certain nervous phases, both in acute and chronic diseases, no remedy can exactly duplicate its action. It is most largely employed in nervous conditions of the debilitated, particularly women and children, in mental disorders, and in stomach derangements and disorders of the reproductive tract with debility and faulty nutrition of the nerve-centers. All through the indications for pulsatilla run depression and irritability with melancholy and sadness, and a disposition to look upon the dark side of life. With this gloomy mentality there is more or less of restlessness. The patient is easily inclined to weep, is unsettled and the mind wanders. Thought is concentrated with difficulty, the pulse is soft, open, and weak, and altogether the patient is miserable and despondent. Scudder, who introduced it into Eclectic practice, declared its most important use is to allay irritation of the nervous system in persons of feeble health, thus giving sleep and rest, preventing unnecessary expenditure of nerve force, and by this means facilitating the action of tonics and restoratives. He found it to be most certain in its action in feeble women and men who have become nervous from sedentary habits or mental overexertion, as well as in the nervousness and restlessness of masturbators, or persons addicted to the excessive use of tobacco. He also declared it the remedy for nervous women when there is debility and faulty nutrition of the nerve centers. Pulsatilla, though a remedy of wide applicability, is particularly adapted to conditions in which the depressed mind is a prominent factor. A gloomy mentality, a state of nerve depression and unrest, a disposition to brood over real or imagined trouble, a tendency to look on the dark side of life, sadness, mild restlessness, and a state of mental unrest generally denominated in broad terms "nervousness", are factors in the condition of the patient requiring pulsatilla. As stated before, the pulsatilla patient weeps readily, and the mind is inclined to wander-to be unsettled. The pulse requiring pulsatilla is weak, soft, and open, and the tissues have a tendency to dryness (except when the mucous tissues are discharging thick, bland material), and about the orbits the parts appear contracted, sunken, and dark¹