Lobelia Inflata

[EMETIC HEEB, INDIAN" TOBACCO. NATURAL OEDER, LOBELIACB^!.]

This plant is said to have been employed by our Indians ; it was introduced to the notice of the profession by Kev. Dr. Cutler, of Massachusetts.

It is a native of North America and begins to flower in July; the flowers are small, of a delicate blue. This drug is well known for its emetic properties; it is a chief anchor of the so-called botanic or Thompsonian practice. It seems to affect chiefly the pneumo-gastric nerve ; in full doses it causes severe and speedy vomiting, attended with continued and distressing nausea, sometimes purging, copious

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sweating and great general relaxation. The symptoms are usually preceded by giddiness, headache and general tremors.

In full, emetic doses, from one to three teaspoonfuls of the pulverized seed, or from five to six of the mother tincture, or in what are commonly, though improperly, called poisonous doses, within from one to four hours all or most of the symptoms above described are increased in intensity. There is, however, an absence of the symptoms of exhilaration, except for a very short time ; the depressing power of the drug quickly appears. There is then severe distress, fulness, weight and tension in the epigastrium, often ex- tending over the hypochondriac and abdominal regions ; difficulty of breathing, tossing to and fro, the person strikes the breast, is very desponding, expresses great fear of death.

The eye rolls beneath the half-closed lid, the pulse is irregular, slow and feeble, or regular and full ; the breathing spasmodic, the perspiration is excessive, the muscular system completely relaxed ; sometimes the brain is affected as by an anaesthetic agent, giving rise to wild and furious delirium ; more often, however, the mind wanders as if dreaming. Suddenly an inclination to stool is felt, but it only amounts to ineffectual efforts, the kidneys pour forth a large quantity of urine ; the person picks and rubs the nose and face, throws about the hands and arms, rubs the stomach and, after a little motion, suddenly vomits, after which he lies back upon the bed, completely relaxed, complains of extreme weakness and prostration, with inability to move.

Sleep follows, for an hour or more, after which he vomits again, sleeps, or is in a kind of semi-somnolent condition ; after resting from one to four hours, he arouses and expresses himself as feeling better than for weeks before. These are the general symptoms manifested after the use of a large dose. When it does not cause emesis, its force is expended in causing perspiration and diuresis. It has no cathartic power whatever, and the reason why. this idea has gained credence is the fact that the drug, by increasing temporarily the nerve force, will enable the system to be impressed by other irritants in the alimentary canal.

In general, in small doses, it does not cause emesis until other functions are stimulated, the emesis being second- ary to other and more general effects. It cannot consistently be called a pure emetic, and emesis is not its primary and principal effect.

The duration of its effects is a matter of some importance. After the system Is brought fully under its influence, this influence may continue from six to twenty-four hours, or even longer.

312 LOBELIA INELATA.

A boy, aged fifteen, being, as bis father supposed, somewhat "bilious," yet in usual good health, took at 9 a. m. one teaspoonful, in decoction, of lobelia seed, in divided doses. In two hours he complained of epigastric pain, fulness, which became more and more severe, until he ran furiously about the room striking upon the epi- gastrium and screaming with the most intense anguish. After this condition had continued for four hours, he vomited bilious matter, and awoke from his condition of partial delirium as from a dream ; no injury followed.

The manner in which this drug causes death is not well under- stood. I do not know of any well-marked case of poisoning on record, and yet, it is thought to be extremely dangerous by the majority of medical men. In the stage of collapse of typhoid and adynamic fevers, full doses have undoubtedly hastened death, more by exhaustion of the nerve force than by producing any lesions per- ceptible by the senses. In one case an emetic of lobelia was directed for a child for that was supposed to be some chronic disease of the digestive organs.

The child took the drug and in a few hours died with symptoms of asphyxia. The post-mortem examination revealed no lesions. A tumor was found pressing on the aorta, which, together with the exhausting power of the drug, produced the fatal result. Massive doses in cases of impeded circulation, produced by organic changes, are dangerous by their tendency to arrest circulation, but in small doses it has an opposite effect in such conditions.

It has been asserted that it causes inflammation of the mucous mem- branes, but of this there is little evidence. Dr. Calkins has known persons to use it for weeks in doses of half a grain of the inspissated extract, once in four hours, without any evident marks of inflamma- tion of the mucous surfaces.

CEREBROSPINAL GROUP.

From ten to twenty drops of the mother tincture, repeated once in from two to four hours, causes, in the adult, pain and fulness of the head, alternating with nausea, with slight giddiness and vertigo, especially during motion. The pain in the head is generally relieved when free diaphoresis occurs.

A prickling sensation throughout the entire body, to the ends of the toes and fingers. The person thus acted upon, opens and shuts the hands as if to awaken them from their loss of normal sensibility. An indescribable feeling of pain and prickling — usually .most severe at the seat of some chronic disease. Oftentimes persons express it

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as if ten thousand needles were piercing through the tissues. The pulse is slower than usual, with free perspiration and debility. The brain is excited, exhibitions of wit are frequent; hearing, taste, smell and touch are more acute than in their normal state, a peculiar calm and placid sensation pervades the system, attended with an in- crease of all the secretions. In some, loquaciousness appears ; in others, excitement ; and in the hysterical, laughter and crying with spasms which are brought on quicker than they otherwise would have come.

In such persons the spasms and convulsions precede emesis.

ORBITAL GROUP.

An increase of brilliancy of expression, with a little dilatation of the pupil.

AURICULAR AND FACIAL GROUPS.

Increased acuteness of hearing. The countenance becomes more animated, and the cheeks are more than usually flushed.

BUCCAL GROUP.

Pungent taste, with a free flow of saliva, and burning in the fauces ; frequent spitting ; prickling in the throat, with burning sensations extending down to the oesophagus. A feeling of pressure as if a ball or foreign substance were in the oesophagus, often causing the patient to make efforts as if to dislodge it; smarting pain and distention in the larynx and pharynx, extending down to the stomach ; frequent deglutition and fulness and pain in the throat.

CHYLO-POIETTC GROUP.

Loss of appetite, thirst, occasional hiccough, with a burning sen- sation in the stomach ; nausea, coming on and disappearing quite frequently, with a rolling, undulating motion ; shaking and shivering preceding emesis which occurs suddenly. Previous to emesis there is often an indescribable feeling of fulness, pain, nausea, with rest- lessness, and irregular and spasmodic breathing. A sensation of weight and over-distention, extending more or. less over the abdomen, especially around the nmbilibus. Rumbling in the abdomen, with a sensation of motion as if about to defecate.

Noack recommends this drug as homoeopathic to some forms of cardialgia, more particularly when characterized by oppression at the stomach, nausea, flow of water from the mouth, disposition to vomit without actually vomiting;.

314 LOBELIA INELATA.

In one case treated by Noack, the patient had a fright which caused a suppression of the menses, nausea, bitter taste, thirst, vomiting of bile, severe pressing in the epigastrium afier eating and also between meals, and always worse in the evening ; oppression and anxiety on the chest and pain in the sacral region ; her tongue had a yellow coating and her pulse was small, weak and slow. A few drops of the tincture of lobelia cured her.

GENITO-URISARY GROUP.

A free secretion of urine. If lobelia is administered in a case of hysteria, violent pain ensues in the womb. In the healthy, a free flow of the menses is promoted.

RESPIRATORY GROUP.

A sense of constriction across the chest and praecordia, irregular spasmodic breathing, sobbing, short and irregular respirations, with dry cough ; sometimes in sensitive persons, it causes a peculiar bark- ing or nervous cough. An occasional deep spasmodic respiration. Asthmatic breathing, with increased labor of the respiratory muscles. A sensation as if a foreign body were at the upper end of the sternum, impeding respiration, with fulness and weight in the epigastrium.

Lobelia seems undoubtedly to be homoeopathic to some forms of spasmodic asthma, more particularly if the asthma is accompanied by nausea and vomiting, a sensation of oppression and weakness at the epigastrium, or a sensation as if a lump had lodged in the throat. In alloeopathic hands, asthma has often been relieved with lobelia upon the alterative principle, by exciting vomiting. The cases where lobelia will really be found homoeopathic to the disease, I think are but few.

In summing up the therapeutic virtues of lobelia inflata, we ob- tain the following series of affections :

SICK HEADACHE, with giddiness, dull, heavy pain in one side of the head, or over the whole head, retching and gagging, qualm- ishness at the pit of the stomach, extreme depression of strength and spirits.

CAKDIALGrlA, with excessive uneasiness and distress in the pit of the stomach, oppression in the epigastrium and on the chest, gagging, vomiting of mucus, prostration.

DYSPHAGIA, of a spasmodic nature, especially in hysteric per- sons, with sensation as if a ball were forcing its way downward in the oesophagus.

ASTHMA, with irregular, jerking respiration, oppression, suffo- cative anxiety as if the patient would die.

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ANGINA FATJCIUM, without any marked symptoms of inflam- mation, with burning prickling in the throat, increased secretion of viscid saliva, nausea, eructations.

CHRONIC VOMITING, coming on in paroxysms, with nausea, profuse perspiration, prostration of strength; after the attack, the patient has a good appetite.

SPASMODIC HICCOUGH, some twenty or thirty turns in rapid succession, with flow of saliva.

PYROSIS, with qualmishness, and flow of alkaline water off the stomach.

CHRONIC BRONCHITIS, with burning prickling in the air passages, hawking up of copious quantities of mucus, copious per- spiration, debility.

HYSTERIA, characterized by fits of laughter or deep melancholy, according to the natural inclination of the patient, debility, profuse menstruation, globus hystericus, palpitation of the heart, oppressed respiration, frequent sighing.

Teste considers it homoeopathic to the itch. There is nothing in the known pathogenesis of the drug that warrants its use in this disease. It is undoubtedly homoeopathic to some of the consequences of repelled eruptions, more particularly nettle-rash, such as : dys- phoea, anxiety, debility, cardialgia, and other affections which have been enumerated in our list.

Lobelia has proved an antidote to rhus tox. A lady in Massa- chusetts was severely poisoned. The usual alloeopathic remedies were applied, lead- water, laudanum, zinc, etc., but all to no purpose. The disease extended over both hands and arms to the shoulders, and over the entire face, causing symptomatic fever and slight delirium.

At 2 p. m., one drachm of the inspissated extract of lobelia was dissolved in a pint of water, and cloths wet in this were freely applied. At the first application, the relief was marked, the smarting subsided, the redness disappeared. The cure was completed in one-half of the usual time of spontaneous cures.

316 LTCOPODIUM CLAVATUH.