Cicuta Virosa

[WATER HEMLOCK, POISONOUS COWBANE. NATURAL ORDER,

UMBELLIFER^E.]

The root of this plant is tuberous and may be mistaken for pars- nip. A characteristic peculiarity of the cicuta root are the cellular hollow spaces, several of which are seen, one above the other, when cutting the root longitudinally. This root yields a light yellow, milky juice, becoming darker in the air. From the root we prepare, before the flowering time arrives, a tincture of a saturated yellow color and a nauseous odor and taste.

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.The stem of the plant is from two to four inches long; it grows in ditches, along the margins of rivers and lakes ; has a general resem- blance to conium maculatum ; the stem is furrowed, smooth, sometimes reddish (the stem of conium is spotted, smooth, has a bluish gloss, and is covered with down); leaves deep green, ternate; leafless serate; umbels upright, flowers white, anthers and style reddish.

From various cases of poisoning, and from experiments made upon animals, Wibmer sums up the action of cicuta in the following interesting statement:

" These observations show that every part of the cicuta virosa is endowed with poisonous properties, the root, herb and seeds, but more particularly the root, and that the poisonous effects of this plant are more especially marked in the spring of the year.

"Its action upon any particular locality is stimulating; hence a small portion taken internally induces increased secretion of saliva, loathing, painful pressure in the stomach ; when taken in larger quantities, it induces a violent, burning pain in the stomach and bowels, eructations, violent desire to vomit, vomiting and loose dis- charges from the bowels consisting of a greenish-black substance. The poison of the cicuta, taken up into the general circulation, man- ifests its noxious effects in remote and important organs. It disturbs and paralyzes the functions of the brain ; in small doses it causes a disposition to sleep and languor ; in larger doses it causes vertigo, delirium, intoxication, diminished suscsptibility of the senses. Symp- toms of an excessive irritation of the spinal cord simultaneously make their appearance similar to those produced by poisonous doses of strychnine, whence arise tetanic and epileptic paroxysms, trismus, spasms of the diaphragm, of the pharynx (constriction of the pharynx), of the bowels and abdominal muscles, eyes, extremities; the lips, tongue and nails assume a bluish appearance during these spasms, the respiration, beats of the heart and irritability of the senses seem suppressed for a time, mingled with occasional rigidity and convulsions of the ^extremities.

" These attacks come paroxysmally, so that the patients have some- times quiet intervals, the functional power of the senses returns, the breathing and the freedom of motion are likewise restored, or the patient falls into a natural sleep. After repeated paroxysms the patient dies from exhaustion or asphyxiated.

The heart and the bowels do not lose their irritability immediately after death ; the abdomen and the whole body swell, and blue spots

720 CICUTA VIROSA.

are seen upon the skin. The venous system becomes predominant, the blood is more fluid. The veins of the brain and lungs are turgid with blood. The stomach and bowels are most generally contracted, red, exhibiting brown spots, inflamed, especially on the folds of the stomach, coecum and rectum, sometimes even ulcerated. The lungs and other organs remain sound.

(This last observation is not correct, for in a case of poisoning re- ported by Velten in Casper's Med. Wochenschrift, which terminated fatally with several of the boys who had eaten of the root, mistaking it for calamus, a post-mortem examination showed that the poison had likewise been absorbed by the respiratory organs ; the lungs were dark-blue, with red points scattered over their surface ; they were very much distended, crepitated when an incision was made into the parenchyma, or when it was compressed between the fingers, and they contained a great quantity of dark-red blood ; the larynx, trachea and bronchia were red ; this redness could not be washed off, and spread continuously over the inner surface of the above-mentioned organs ; the internal surface of the bronchia was lined with a reddish mucus. Wepfer reports the case of a young man of twenty, which terminated fatally ; the lungs exhibited a number of blue and yellow spots.)

Still more recent experiments throw additional light upon this in- teresting point. Professor Boehm has obtained a substance possessing the peculiar properties of the plant, which he names cicutaxin. * * * Experimenting upon frogs, it was ascertained that the hemispheres had nothing to do with the development of the cicuta spasms, nor does the cerebellum share in them. If a section is made through the spinal cord below the calamus scriptorius, the parts sup- plied by the spinal nerves given oif below the section are paralyzed, while their reflex irritability remains.

These are the characteristic spasmodic movements of the head, neck and chest, and the peculiar cry. The latter is explained by the excess of inspiratory over expira- tory action on filling the lungs. Then, when the spasmodic seizure sets in, the abdominal muscles^ contracting, force the air out again through the larynx, which is itself spasmodically narrowed. In mammalia, after ingestion of the poison, there is a period of repose lasting from fifteen to thirty minutes.

Then the animal grows uneasy and is soon attacked by the characteristic violent tetanic spasms. The immediate cause of death is deficient respiration. When given by the mouth, about three-quarters of a grain of cicu-

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taxin to every two in weight will be a fatal dose for a cat ; but more will be needed for a dog. The action of the poison is exerted upon the medulla oblongata. (Schmidt's Jahrbuch, 1876.)

EPILEPSY We may exhibit this agent in epilepsy and epilep- tiform spasms, more particularly the ganglionic form of this disorder, according to the pathology of Schcenlein. Some of the cases re- ported by Wepfer exhibit paroxysms of convulsions which simulate epilepsy. In one case the record reads : Horrible epileptic paroxysms, recurring at first at short and afterward at longer intervals ; the limbs, head and trunk are moved in a very strange manner, the jaws are locked.

In another case the paroxysm is recorded in this man- ner : Epileptic attack with strange distortions of the limbs, trunk and head, with bluish face and suppression of breathing which con- tinued for a few moments, froth at the mouth ; after the convulsions ceased and the respiration was easy, he seemed unconscious, lay like a dead person, and seemed without sensation, whether spoken to or pinched even.

In another case the patient is said to have been attacked with spasmodic distortions of the limbs which threw him to the distance of two feet.

OHOEEA. — Oicuta may prove useful in some of the more fright- ful forms of chorea, characterized by excessive mobility and contor- tion of the limbs.

CONVULSIONS (hysteric and tetanic) come within the curative sphere of this drug.

The following series embodies all the leading symptoms by which the convulsions with which the cicuta poison may be said to be in homoeopathic relation, are characterized : Vertigo so violent that the patient falls down ; loss of sense ; redness and bloating of the face, with protrusion of the eyes, staring look, haemorrhage from the ears, swelling of the neck, gritting of the teeth, foam at the mouth, ina- bility to swallow, thirst during the spasm, spasmodic hiccough, vomi- ting (even of blood), burning and anxiety in the epigastric region, throbbing in the pit of the stomach which had swelled up to the size of a fist, desire for coal which was actually swallowed, retention of urine or sometimes violent, spasmodic spirting out of the urine, hoarseness, jactitation of the limbs, intermittent breathing, excessive chilliness, perfect immobility and loss of sensation after the cessation of the paroxysm.

CEREBRO-SPINAL MENINGITIS, presents many symptoms

VOL. I. — 45.

722 CICUTA VIORSA.

found in the pathogenesis of the water hemlock. In the Transac- tions of the Central N. Y. Horn.

Med. Society of 1872, we find the following symptoms of the drug grouped together : Moaning and howling ; disposition to be frightened ; grinding of the teeth ; diplo- pia ; dilated or contracted pupils ; dumbness ; deafness ; dyspnoea ; dysphagia ; ashy paleness, or bluish puffed face ; cramp in the cer- vicle muscles, with inability to move the head after it has been turned in any direction ; stiffness of the neck, not permitting the head to be turned ; tension and soreness of the muscles, with retrac- ted head ; tonic spasms of the cervicle muscles ; trembling of the limbs ; startings and convulsive movements of the limbs ; convul- sions with cries ; pressing together of the jaws ; numbness and distortion of the limbs; suspension of respiration; foam at the mouth ; opisthotonos ; violent, sudden jerks through the head, arms and legs ; after the fits the body remains insensible, as if it were dead ; insensibility and immobility.

Dr. Hale, in an article on Remedies in Oerebro-Spinal Meningitis (U. S. Med. Jour., Jan., 1873,) speaking of the use of cicuta, reports among others, the following case from the practice of Dr. Baker :

David Gray, aged seventeen years, had been sick under medical care for five weeks. Previously, in the same family, three children had died of the same complaint ; this was the last one living. He was in the following condition: Head retracted; rigid spine; pupils dilated; diplopia; rapid pulse; perfect deafness; dumb for several days; dyspnoea; dysphagia; no muscular flinching when the trunk or lower extrem- ities were pricked with a pin ; perfect paralysis, had not moved or winked in several days.

Cicuta virosa209. Next morning the patient could breathe more easily, and there was less strangling when taking the medicine. On the third day, no strangling; has taken a little chicken broth. Fourth day : patient has been winking all night ; no strangling ; can now speak.

After this he steadily progressed to a perfect cure, taking no other medicine. For a while he walked on crutches, but was otherwise well, and in three months he was perfectly restored.

MANIA. — In certain forms of mania, cicuta may prove useful ; in one case of poisoning, the patient, after waking from a profound sleep, jumped out of the bed, danced, laughed, and was guilty of all sorts of absurd actions, drank a good deal of wine, jumped about, clapped her hands, and looked very red in the face all night.

PUSTULOUS ERUPTION— Cicuta has also been recommended as a remedy for the cure of a pustulous eruption in the face and on the hairy scalp. Upon one of the pro vers of cicuta such an eruption was produced.

Frederick Hahnemann reports the following effects of cicuta on his own person ; " Blotches in tne face and on both hands, of the size of split peas, at first causing a burning pain and afterward running

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together, of a dark-red color and continuing nine days, at the lapse of which period desquamation took place lasting three weeks."

Hahnemann himself adds in a foot-note : "I have cured long-last- ing confluent pustulous eruptions in the face, causing a burning pain, with one or two doses of cicuta ; but I always allowed the first dose to act three or four weeks before I gave the second dose, if a second dose was at all required."

Cicuta affects the sense of vision more or less. In one of the pro vers of cicuta, it caused diplopia, or double vision ; objects were seen double and they looked black ; at times she became hard of hearing. Hence we may derive good effects from the use of this drug in

AMAUROTIC CONDITIONS of the eyes, where these symptoms occur; this species of amaurosis will generally be found accompanied by signs of cerebral congestion, dizziness, frontal headache.

Dr. C. P. Hart (Am. Observer, Sept. 1877,) says: "Cicuta .

Diplopia ; things look black ; eyes portrude, with a staring look ; pupils first contracted, then considerably dilated ; when standing or walking, the sight vanishes, and objects appear to advance, recede, and waver, from vertigo. Cicuta has cured double vision, vertigo, blepharitis with agglutination of the lids, and photophobia; but its chief value appears to be in spasmodic affections of the eyes and lids."