Veratrum Viride

[AMERICAN HELLEBORE. NATURAL ORDER, MELANTHACE^E.]

Leaves lance-oval, acuminate ; stem stout and very leafy ; panicle compound, racemous; bracts oblong-lanceolate, bracteoles longer than the downy pedicles. Canada to Georgia. A large-leaved, coarse-looking plant, of our meadows and swamps. Root large, fleshy, with numerous long fibers. Stem two to four feet high, striate and pubescent. Leaves strongly veined and plaited, the lower near a foot long and half as wide, sheathing at the base. Flowers numerous, green, in many axillary (or bracted) racemes,

878 VERATRUM VIRIDE.

which together form a very large, pyramidal, terminal panicle. July. (Wood.) This plant grows in marshes, in damp meadows, in the neighborhood of streams.

The root is officinal. It should be dug in late fall and used fresh. It possesses a bitter acrid taste which remains in the mouth a long time. The powdered root provokes violent sneezing. Jervia and veratroidia represent the active principles of the drug; the pure resin is nearly inert.

Drs. Osgood and Ware first investigated the medicinal properties of this plant. Both thought its action similar to that of veratrum album, but the former denied its possessing cathartic properties. It produced upon him violent and frequent vomiting, and, in larger doses, caused great nervous prostration, drowsiness, vertigo, head- ache, dimness of sight, enlarged pupils; in still larger doses, it reduced the pulse, even to thirty-five beats in the minute.

Dr. Ware reports a case in which the application of American hellebore to an ulcer on the leg caused violent vomiting. A Mr. Worthing- ton took one-fourth of one grain of the alcoholic extract, and experi- enced : acrid, burning sensation in the mouth, which commuuicated to the throat and fauces a sense of dryness and heat, which finally reached the stomach.

In the course of half an hour, this sensation of dryness and burning in the throat and stomach became intense, and was followed by frequent hiccoughing, attended with nausea, retching and vomiting ; the latter was violent, and came on every ten or fifteen minutes for the space of an hour. There was also dizziness and tremor, which passed off gradually. With the hic- cough, there was a copious secretion of saliva and discharge of mucus from the stomach and nose ; the pulse became scarcely per- ceptible, and was reduced from sixty-eight to fifty-two beats per minute.

This experiment was repeated three times, and in neither was there a disposition to catharsis ; the effects obtained were those of an acro-narcotic.

Drs. Norwood and Cutter, members of a special committee appointed by the Massachusetts Medical Society for the study of the medicinal property of this plant, called the attention of the profes- sion to the remarkable powers of this plant as an arterial sedative in the treatment of inflammatory diseases. The first article in homoe- opathic literature upon veratrum viride appeared in the Philadelphia Journal of Homoeopathy, vol. i. (1852-3), and was written by Dr. John H. Henry-

VERATRUM VIRIDE. 879

I was summoned to see a gentleman, a scientific chemist, who had taken, experi- mentally, one drachm of the tincture of green hellebore. On my arrival, I found him sitting in the water-closet, vomiting into a pan. His features were sunken, skin cold, and covered with a profuse, clammy sweat; his pulse quite imperceptible. He complained of intense pain about the epigastrium.

The vomited matter appeared at first to consist of the food and contents of the stomach ; afterward, of glairy mucus. I gave him immediately an ounce and a half of pure brandy, which at once checked the vomiting. At this point I was joined by the patient's usual medical attendant. As he had slightly rallied, we had him removed into a room a few yards from the water-closet, and laid on the couch in front of the fire.

The surface of the body was still very cold, especially at the extremities. The clammy sweat continued, but the pulse could be felt indistinctly, beating, very feebly and irregularly, forty-four in the minute. A dose containing spirits of gether sulph. co. 3ss., and spirits amnion, arom., 3i., was given, but immediately rejected by the stomach ; but some brandy, given directly afterward, was retained. A large mustard poultice was applied to the epigastrium, and a hot-water bottle to the feet.

Two or three efforts at retching took place afterward, and once or twice he vomited food, mucus and a small quantity of blood. Warmth gradually returned to the surface, and the pulse became somewhat better in volume and in power. Brandy was given at short intervals, and, after about an hour, a second dose of a?ther and ammonia, which was retained. The patient then fell asleep, slept for about a quarter of an hour, and awoke with the expression, " I am all right now," and appeared comparatively well.

There was no diarrhoea throughout. He had, two or three times, a slight return of the symptoms ; did not sleep during the night, but was quite easy, and the next morning only felt the discomfort arising from the mustard poultice, and the soreness of the muscles caused by the retching. The patient then stated he had taken one teaspoonful of the tincture at about 4:45 P. M., with the following results : Uneasiness at the stomach ; constriction of the stomach and tendency to sickness, causing him to retire to the water-closet.

The sickness, once commencing, soon became alarmingly violent, with the most excrutiating pain in the lower part of the stomach, the pain extending to about the size of his hand; tea, warm water, etc., seemed " to go under the pain," making the constriction more and more violent. Pain continued to increase. Vom- iting of glairy mucus streaked with blood set in, with running from the nose and eyes. Painful and profuse sweating now set in, also difficult and labored breathing.

Heat and constriction of the throat ; the mind was perfectly calm ; not alarmed at the thought of probable death. Loss of consciousness, with vertigo and disturbance of vision (immense circles of green color appearing around the candle and changing to red upon closing the eyes). Excrutiating pain at the stomach continued; ten- dency to cramp when the legs were touched. He recollected the sting of the mus- tard poultice, and the horror of being forced to swallow brandy.

The bowels were not acted upon at all. (Dr. G. N.

Edwards, in Med. Times and Gazette, Jan., 1863.)

The following proving of veratrum viride was made by Dr. Burt :

Dec. 21 In perfect health ; bowels regular once a day: pulse seventy-four; res- piration twenty. Took thirty drops of the 3d decimal dilution of fluid extract of veratrum viride in water. At 10 A.

M., ten minutes after, sharp drawing pain over the left eye, with a contracted feeling of the skin of the forehead ; at 10:30 constant, dull frontal headache, with neuralgic pains in the temple, close to the eye; II A. M., dull pains over the eye, with quite severe drawing pains in the umbilical region . pulse sixty-seven ; took fifty drops; 12 M., slight frontal headache, with pricking pains in the region of the heart; frequent drawing pains in the umbilical region; pulse seventy.

Took sixty drops ; 2 P. M., drawing pains in the forehead ; natural stool. Took one hundred drops; 3 P. M., dull frontal headache, with pricking pains in the precordial region.

Took one hundred and fifty drops ; 5 P. M., slight frontal headache ; neuralgic pains in the region of the heart and cardiac portion of the stomach. Took two hundred drops ; 7 P. M., very frequent neuralgic pains in the •cardiac portion of the stomach.

Took one hundred and seventy -five drops ; slight

8 SO VEKATRUM VIEIDE.

dull frontal headache ; neuralgic pains in the right side of the umbilicus, passing down to the groin ; slight drawing pains in the right elbow and calves of the legs ; sharp, flying pains in the epigastric and umbilical regions. Pulse sixty-six.

Dec. 22 Slept well, but had frightful dreams of being on the water; feeling well ; pulse seventy-nine. 9 A. M., took three drops of the fluid extract of veratrum viride. Slight, dull frontal headache, with a contractive feeling of the skin of the forehead ; pulse seventy-six. 10 A.

M., respiration easy; took four drops. II A. M., same dull headache ; neuralgic pains in the temples ; sharp pains in the epigastric and umbilical region; pressing down to the pubes; pulse seventy-one. 12 M., took five drops. 2 p. M., very severe frontal headache, with dull, aching pains in the umbilical region ; pulse seventy-four.

Took six drops; 4 p. M„ same headache ; pulse seventy. Took six drops; 9 P. M., same headache, with neuralgic pains in the right temple; tongue feels as if it had been scalded ; dull ache in the epigastrium ; very sleepy.

Took eight drops.

Dec. 23 Had a restless night ; frightful dreams of people drowning; flat taste in the mouth ; tongue coated yellow along the centre ; soft, papescent stool. At 9 A. M., took ten drops ; pulse seventy. 10 A.

M., there has been constant and severe cutting, aching pains in the umbilical region, with rumbling in the bowels, with a soft stool. Took twelve drops ; dull, heavy aching in the region of the gall bladder, with dull pains in the umbilical region ; arms ache. 12 M., took twelve drops. 1 P. M., very severe aching in the back of the neck ; very difficult to hold my head up ; constant burning distress in the region of the heart; am very weak and tremble all over; pulse forty-six, soft and very weak, can hardly be felt; mushy stool, without pain. 2 P.

M., dull frontal headache ; face is very pale ; nose looks pinched and blue ; constant hiccough, with violent and constant spasms of the upper part of the oesophagus ; cannot swallow ; profuse vomiting of thick, glairy mucus and water ; profuse secretion of tears, and mucus from the nose, also saliva; neck aching severely; pulse 44; soft and very weak. 2:20 p. M., violent vomiting, with severe frontal headache and hiccough ; cannot walk ; if I attempt it, I am very faint and completely blind; obliged to keep in the horizontal position. 4 p. m., pupils- dilated; neck and arms ache severely; dull ache in the umbilical region, with rumbling ; cannot walk across the room without becoming blind ; pulse forty-four, soft and very weak. 5 P.

M., constant, dull, aching pains in the umbilicus, with sharp, neuralgic pains in the left groin ; can walk about ten rods, when I become blind, and am compelled to sit down; pulse forty-six. 8 P. M., feeling much better* pulse sixty-one, soft and weak ; constant dull pain in the umbilicus, and pain in the region of the gall bladder. Took eight drops and retired.

Dec. 24 Slept sound ; frightful dreams of the water, as usual ; flat, bitter taste in the mouth ; tongue coated yellow along the centre ; slight, dull pain in the bowels ; pulse sixty-four, soft and full. Took ten drops ; at 8 A. M., dull, aching pain in the umbilicus; by spells, they are very sharp and shooting; dull pains in the region of the gall bladder ; tongue feeling as if it had been scalded.

Took ten drops at 10 a. M. 12 m., dull frontal headache ; dull pains in the umbilicus, followed by aching in the rectum; pulse thirty-five, soft and very weak. Took ten drops; 1 p. m., very severe frontal headache ; hiccough, with constant and severe spasms of the upper part of the oesophagus ; violent vomiting of my dinner, and then of a thick, glairy mucus ; the secretion of saliva, mucus from the nostrils, and tears is profuse ; dull, aching distress in the umbilical region ; back of the neck and arms atme severely ; almost impossible to hold my head up ; pulse forty-four, soft and very weak, can

VERATRUM VIRIDE. 881

just be felt ; can walk about four rods, I then become blind and faint, but can sit up without any trouble. 2 P. M., hiccough lasted two hours, also the spasms of the oeso- phagus; dull, frontal headache; severe aching in the neck, very much worse by moving; dull pain in the bowels; pulse forty-six, sitting or lying down; constant and dull aching ; burning pain in the region of the heart, under the sternum ; ring- ing in the ear; moving quickly makes me very deaf. 3 v. M., dull, hot, aching pain in the region of the heart ; dull pain in the umbilical region ; pulse forty-six, soft and very weak. 5 p.

M., pulse fifty-seven, soft and weak, burning distress in the region of the heart; dull pains in the umbilicus. 6 p. m., pulse sixty; same distress in the region of the heart; dull pain in the bowels ; 10 p. m.., pulse sixty-six; dull pain in the umbilicus, with desire for stool ; mushy stool, followed by an aching sensation in ' the rectum. Morning, feeling well; pulse sixty-six, small, quick and hard.

Writers of the physiological schools view with particular interest the action of veratrum viride upon the pulse-beat and upon the temperature of the body. The nausea which is observed in all prov- ings of the drug, the loss of muscular power, the general and profound prostration, vertigo and loss of vision — all these are symp- toms of great interest, and are pointed expressions of the action of veratrum upon the cerebral centres. In full therapeutic doses it lowers the pulse rate both by a direct action on the muscles and by stimulating the inhibitory nerves ; it diminishes the force of the hearc-beat by a direct influence on the cardiac muscle, and produces a general vasa-motor paralysis more or less complete according to the size of the dose.

(Dr. H. C. Wood.)

CEPHALIC GROUP.

Veratrum viride prostrates the functions of the brain and pro- duces a well-marked congestion of the capillary vessels. Microscop- ical examination of the brain of animals poisoned with this drug showed intense capillary congestion of the white and gray substance of the brain ; the congestion was particularly marked in the cere- bellum. Drs. Burt and Hale found great capillary congestion of the pons varioli ; this furnishes the reason why the remedy is so valuable in spasms of a congestive nature.

Provers have recorded the following symptoms : Stupefaction ; loss of memory ; vertigo ; depression of spirits. Dull, heavy, frontal headache, also with neuralgic pains in the temples ; very severe ache in the back of the neck, with difficulty of holding the head up; headache with nausea and vomiting ; pinched and blue appearance of the nose ; attempts to walk cause faintness and blindness ; the aching in the back of the neck is very much worse by moving it ; ringing in the ears ; deaf- ness upon moving quickly.

Headache with vertigo, dimness of vision and dilatation of the pupils. The face is cold, bluish, covered

VOL. II. — 55.

882 VERATRUM VIRIDE.

with cold sweat; or, flushed, congested. Dimness of vision with dilated pupils ; twitching, contortions of the eyes ; paralysis of the eyelids. Disturbances of vision — there were green and red circles around the candle. Also, tendency to spasms of the muscles if the legs were touched ; spasmodic contraction of the upper part of the oesophagus.

CEREBRO-SPINAL MENINGITIS.— Veratrum viride is of par- ticular value in the treatment of cerebro-spinal meningitis, with symptoms of intense cerebral congestion, feeling as though the head would burst open, sudden spasms with nausea and vomiting and great prostration. (Burt.) We may also have : high fever, violent headache, restlessness, aching in all the limbs, sensitiveness to touch ; stupor ; convulsions, provoked by touching the muscles ; contraction of the nape of the neck or of one side of the neck, throwing the head backward or toward one side ; convergence of the eye, double vision.

A boy of three years was suddenly attacked with vomiting and purging, which lasted three hours. Under the influence of arsenic, these symptoms passed away, but were followed by great soreness of the body and headache. The pulse increased in frequency; the temperature rose, the child complained of severe pains in the back and head, and screamed in agony, if touched or moved. The head was bent backward and rigidly contracted.

The child was restless, constantly cried for water, and moaned and screamed continuously. As the disease progressed the spasms became more violent, the body bent more rigidly backward, causing opisthotonos. During the first twenty-four hours, aconite and bryonia were given in alternation every twenty minutes. Up to this time the child was conscious, calling for water every moment, and so restless, that it required the attendance of several persons to keep him in bed.

The tetanic spasms became more violent, the opisthotonic condition more marked, the heels and back of the head only touching the bed. The child be- came unconscious and ground its teeth. There were also alternating spasms, first of one arm and leg and then of the other. The arms and wrists were rigidly flexed and bent outward and backward.

The child also vomited quite a good deal of dark matter, looking like coffee-grounds. Herpetic eruptions appeared on the arms, and the face and mouth were covered with them. The teeth were so firmly set that medi- cine could not be given by the mouth, hence twenty drops of the tincture of veratrum viride were mixed in a half pint of water and two table-spoonfuls injected per rectum every half hour. In three hours the spasms had moderated considerably.

At the expiration of four hours the head was less rigidly bent backward, the general spasms were less in number, and the child had intervals of quiet every few minutes. Three drops of the veratrum were now dropped into half a glass of water for internal use. In twenty-four hours all spasmodic action had ceased and the child had moments of consciousness. From that time the patient improved slowly but gradually.

All throughout the latter part of the disease purple- colored spots appeared on various portions of the body, coming and going irregularly. The complications which fol- lowed the disease were met by other remedies. (Dr. J.

Martine Kershaw in U. S. Med. Investigator, Oct.

I, 1879.)

CONVULSIONS. — The American hellebore is a most important remedy in convulsions, especially of the puerperal state. Raue gives the following, somewhat vague, indications: during parturition; also after blood-letting ; during the puerperal convulsions, causing

VERATRUM VIRIDE. 883

furious delirium, cold, clammy perspiration. The following case will serve to illustrate further.

Mrs. R., aged twenty-one years; short in stature; muscular system well devel- oped; first labor; previously health good, with exception of some suffering at each monthly period. * * * Found her near the close of the eighth month of preg- nancy. She was suffering from irritation of the vulva, rendering this region very sensitive to the touch. Pulse short, quick and wiry.

Had urinated freely, bowels in a normal condition. Labor had commenced, vertex presenting in the left occipito- ilrac anterior position ; plenty of pelvic capacity and labor advancing finely ; expected a speedy delivery. At 8 P. M., during a forcible pain, was suddenly and fearfully convulsed ; the head of the child was now engaged in the inferior strait and advanc- ing with every pain ; these convulsions continued with very short intermissions, until she had had seven, when we concluded, having previously called my father in consultation, to extract the head of the child.

This I was obliged to do with the blunt hook, as my patient, between the paroxysms, was unconscious and continually throwing and rolling herself from one side of the bed to the other; very restless and very strong, rendering the liability of injury to both mother and child very imminent if the forceps were used. Notwithstanding the removal of the apparent exciting cause, the convulsions continued with the same, if not greater, severity; several rem- edies were used without benefit.

She remained in much the same condition the whole time, with the exception that she had no convulsions from about eleven o'clock of each evening to three or four o'clock of the next morning, being apparently in a heavy sleep during these periods ; rousing but once or twice, then calling for water and again relapsing into the same, heavy, soporous condition. The convulsions began by opening the eyes, which were previously closed, and a convulsive move- ment of the sockets, drawing them upward and to the right side, and the head back- ward and to the same side ; then followed a rigidity of the arms, stretching them above the head, with the thumbs between the first and second fingers of the clenched fists; the mouth was drawn to the right side ; violent palpitation and fluttering of the heart ; arrest of breathing ; blueness of the face ; foaming at the mouth ; chewing of the tongue ; extension and stiffening of the lower extremities ; and a general trembling of the whole body.

Each convulsion ceased in from five to six minutes, although at times she would have two or three immediately following each other. Between the paroxysms she lay in a deep, heavy sleep, with stertorous breathing. After three days of unconsciousness she recovered finely, the bad feelings in the head rapidly disappearing ; having had no convulsions after taking the first dose of vera- trum viride tincture, one drop in a half tumbler of water, a teaspoonful at first every half hour, afterward at longer intervals.

(Dr. F. W. Payne, Hahn.

Monthly, June, 1868.)

HYPEREMIA of the brain, active or passive, often finds its remedy in veratrum viride. It is indicated when we have : a sense of fulness, weight, or of distention in the head ; giddiness, intense headache, throbbing of arteries, stupefaction ; double, partial, lumi- nous visions, nausea, vomiting; tingling numbness in the limbs; mental confusion, loss of memory, convulsions, paralysis. In

HEADACHES which arise from a congested state of the brain this remedy is frequently of service. The effects of sunstroke and of alcoholic stimulants may be mentioned here ; in some cases of menstrual headache, with congestion to the brain and the symptoms furnished under hyperasmia, we may find veratrum a valuable remedy,

• NERVOUS GROUP.

Veratrum viride affects particularly the motory nervous system,

884 VERATRUM VIRIDB.

producing more or less complete paralysis and violent convulsions. Its great muscular prostration depends largely upon its action upon the nervous system. We find recorded the following symptoms : The mouth is drawn down at one corner ; spasm of oesophagus, with or without rising of frothy, bloody mucus ; sensation as of a ball rising into the oesophagus ; contraction of the muscles of the back, drawing the head backward ; opisthotonos, with wild arterial excite- ment, congestion of the brain, loss of consciousness.

Ehenmatic pains in the limbs, transient, flying ; twitchings and contortions of the body, unaffected by sleep ; with frothing at the mouth ; violent spasms, like galvanic shocks. We find veratrum viride indicated in CHOREA with violent contortions, general, unaffected by sleep, and characterized by symptoms described above.

A. M., aged eleven years, chorea for a month, and had been getting worse very rapidly the last week ; movements continue in sleep, throws about his arms and legs when asleep; is unable to hold a spoon in his hand, so he has to be fed by another person ; speech is affected, at some times more than at others ; he drops his words when speaking; he complains of pain in his hands if he keeps them still for a few moments together. Is constantly on the move, as to his legs and arms ; since the choreic movements showed themselves, he has been continually eating.

Prescribed veratrum viride gtt. v. add aqua §iii. The pain he complained most of was a pain extending up the arms and shoulders to the head, and a like pain in the legs, the pain in the arms being much the worst. Better in every respect ; sleeps well, appe- tite more natural, used to eat continually, but now he eats less frequently and more heartily, and he is not nearly so faint; he has since remained perfectly well. (Dr.

R. T. Cooper, Brit. your. Horn., vol. xxxiv., p. 272.)

SPASMS. — Veratrum viride is of great use in diseases character- ized by spasms, clonic or tonic, and even in opisthotonos. In the

ECLAMPSIA OE CHILDREN, who have become thoroughly anaemic in consequence of long-continued diarrhoea, it is an excel- lent remedy; it has been found serviceable in spasms caused by poisoning with strychnine.

INFLAMMATORY GROUP.

Veratrum viride affects particularly the brain and the organs under the control of the pneumo-gastric nerve, viz. : the organs of the chest and upper abdomen, especially the stomach.

Veratrum has, in its record, labored breathing; oppression of the chest ; short, dry, hard, hacking cough ; chilliness, coldness, irrita- tive fever. Drs. Burt and Hale, moreover, have demonstrated, by their experiments upon dogs, that American hellebore causes inflam- mation and hepatization of lung tissues. All schools of medicine in the treatment of *

PNEUMONIA use it with excellent success. The physiological

.VERATRUM VIRIDE. S,S,">

school claims that it lessens the force of the blood-current and diminishes its rapidity, thus guarding against its too forcible afflux to the seat of inflammation ; it exerts a sedative influence upon the nervous system, the excitability of which is increased in proportion to the extent of the inflammation. Venesection meets both of these requirements, but bleeding impairs the quality of the blood by a direct withdrawal of a portion of its solid and fluid constituents. As the blood, by endosmosis, soon regains its quantity, but not its quality, depletion becomes necessary again and again, and there is a continued abstraction of successive amounts of chemical and histo- logical elements, which it is difficult to replace.

Hence the prefer- ence for veratrum. We prescribe veratrum viride in the earlier stages of the disease, when there is a quick, hard pulse, sometimes regularly intermittent. Nausea and faintness' at the stomach; anxious oppression of the chest ; the tongue has a red streak through the centre and is coated on the sides ; it feels as if it had been scalded. The latter symptoms are of marked importance, and, with other symptoms, occasionally demand the exhibition of this remedy in the latter stages of the disease.

The remedy is also to be con- sidered in

CONGESTION OF THE LUNGS, the symptoms resembling those given under pneumonia.

On the 15th of October I was called to a case of undoubted congestion, in a child seven years old. The patient had been suffering from a severe cold for some days ; while at play on the preceding day, he accidentally slipped into a lake near the house, and soon after was attacked with rigors coursing up and down the spine, high fever, face deeply flushed, eyes red and protruding, hurried respiration with great dyspnoea, and exceedingly rapid pulse. The skin was hot and pungent to the touch over the whole surface of the body.

Pupils of the eyes dilated. * * * I gave veratrum viride, 1st decimal dilution, twenty drops in a half a glassful of water, two teaspoonfuls every hour. The pulse at the time of administering the first dose was 150 beats per minute. Eight hours later I saw the patient, found the pulse only 83 beats per minute, fever and heat much diminished, dyspnoea greatly relieved, the pupils much smaller and, in every way, a marked change in the force of the disease. I now gave veratrum viride, 3d centesimal, twenty drops in half a goblet of water, one teaspoonful every two hours.

On the 16th, I found the boy sitting up in bed, busily engaged with his toys. Two days afterward the patient was discharged as cured. (This case is one of thirty in my own experience.)

INFLAMMATION OF THE HEAET-MUSCLES— Veratrum yiride has also been employed in inflammation of the pleura and of the pericardium; in inflammation of the heart-muscle the physio- logical school use it to control the arterial excitement. We pre- scribe it when there is: faintness after rising from a recumbent position, syncope when walking, relieved only by lying down ; the cardiac difficulty is a sequela of haemorrhages, slow, protracted fevers.

886 VERATRUM VIRIDB.

Veratrum viride has caused : Uneasy constriction of the stomach, with a tendency to vomit ; excrutiating pain in the stomach, with violent nausea and vomiting of food, later of glairy mucus streaked with blood ; excrutiating pain in the stomach, with heat, and con- striction of the throat; painful, empty retching; great irritability of the stomach, the smallest quantity of food is immediately re- jected ; the pain in the stomach would culminate every five or ten minutes in powerful, expulsive vomiting; vomiting produced by spasmodic contraction of the stomach only. These symptoms lead us to to the use of hellebore in

GASTKALGIA, and in all neuralgic and spasmodic affections of the stomach, characterized by symptoms similar to those enumer- ated. Dr. Burt inclines to the belief that veratrum viride causes, and hence may cure, true inflammation of the stomach. Dr.

Nor- wood, who has carefully studied the action of this drug, maintains that this is not the case ; we believe that it causes a violent conges- tion of the mucous membrane of the stomach rather than a true inflammation ; certainly, we fail to find positive clinical evidence to substantiate the claim of the former authority.

Veratrum has also caused: Yellow coating of the tongue; bitter taste in the mouth; the tongue feels as if it had been scalded. Copious secretion of saliva. Sensation of burning in, and spasms of, the oesophagus, with rising of bloody mucus in the mouth. Vomiting of blood and bile ; hiccough before and after vomiting.

Frequent drawing pain in the umbilicus ; cutting and aching pains in the bowels with a desire to pass stool. Mushy stool preceded by cutting pain in the bowels, and followed by cutting pains in the rectum and anus. These symptoms are of value only as a part of the totality of symptoms.

INFLAMMATOKY EHEUMATISM— It may not be out of place to speak, in this connection, of the use of this drug in the treatment of inflammatory rheumatism. We use the remedy with considerable confidence when the seat of the disease is in the shoulder, hip or knee, with a tendency to metastasis to the heart ; there is the characteristic pulse, and the tongue shows the peculiar red streak in the centre, with a coating at each side.

Case I. A boy, aged five years. Did not look well, had no fever, but complained of pains in the abdomen. When he walked it seemed to hurt him, as from a jar. Prescribed for indigestion February nth. Two days later the attendant found a well developed case of inflammatory rheumatism, affecting principally the knees and ankle-joints, with some swelling and pain of the wrists and fingers. On the 13th, the parts were swollen and sensitive to motion and touch ; some general fever, but

VERATRUM YIRIDE. 887

not very great ; his tongue showing very plainly the " red streak and yellow coated sides." Veratrum viride, tincture, six drops in two ounces of water, was given, a teaspoonful every two hours. The next day he was walking about the hous'e, with- out pain or soreness, and with very slight swelling left. (Dr. Hasbrouck in Am. Observer, 1873, P- 25^0

Case II. A married lady, aged thirty, was taken on February nth with creeping chilliness, aching in all the bones, followed by headache and high fever. On Febru- ary 13th, the ankle-joints and calves of the limbs were swollen and very painful when moved, and also sore to the touch. She had also a high fever with headache.

All the other aches and pains were confined to the lower limbs. Her tongue showed the red streak. Veratrum viride was given as in Case I., using a dessert-spoon in- stead of a teaspoon. The next day the patient was up, fever and pains gone and feeling well, but somewhat weak.

Next day she complained of lameness and sore- ness of the right shoulder-joint, for which she received one drop of veratrum viride, tincture, in a half goblet of water, a dessert-spoonful every two hours, the remedy relieving the case promptly. {Ibid.)

SEXUAL GROUP.

In the absence of anything better, we depend almost exclusively upon clinical evidence for our knowledge of the value of this drug in diseases of women. We have already referred to its use in men- strual headaches and in 'puerperal convulsions. It may also prove useful in

PUERPERAL METRITIS, if indicated by characteristic symp- toms, and in

DYSMENORRHEA with violent menstrual colic before the appearance of the discharge, and with symptoms of strangury. Dr. R. Ludlam recommends veratrum viride in the treatment of

PELVIC CELLULITIS. "Its wonderful power to control and to regulate the vascular movements, to equalize the circulation and, as it were, to stamp out a local congestion that would almost inevit- ably result in inflammation, is being recognized by physicians of all schools. My experience has satisfied me that this drug holds some specific relation to the female generative system. Precisely what that relation is, I cannot say.

But it appears to be especially adapted to the relief and removal of puerperal inflammation. * * * It restores the milk and lochia, when these have been suddenly sup- pressed, quiets the nervous perturbation, relieves the tympanitis and the tenesmus, whether vesical or rectal, and frequently cuts short the attack."

FEVER GROUP.

Chilliness. Coldness of the whole body with cold sweat ; profuse and cold perspiration ; chilliness with nausea ; qnick weak pulse. Cold, blue face. Restless sleep, dreams of drowning. Veratrum viride may be used in

888 YERATRUM VIKIDE.

INTERMITTENT EEVER, when the cold stage is very promi- nent; there is a coldness "inside," but soon the body feels cold to touch ; symptoms of congestion, especially as the hot stage develops, with oppression of the chest, pressure and ache in the brain, excessive prostration, characteristic coating of the tongue. Convulsions, especially in children. Cold, clammy sweat.

BILIOUS FEVER with persistent, painful vomiting with much retching, utter prostration, cold clammy sweat.

TYPHOID FEVER with full, hard, quick pulse. Violent pain in the back of the head. Delirium. Black stools. (Dr. Hering.)

A little girl, aged thirteen years, had been suffering with continued fever for ten days. She complained of violent pain in the back ; inclined to sleep most of the day ; very sick at the stomach, but not so as to produce vomiting ; black diarrhoea ; pulse varying from 98 to 1 10 during the day ; pain and weakness in the lower limbs. I t^ok the case to be a mild form of typhus. I immediately placed five drops of the mother tincture in a tumbler half full of water, ordered a teaspoonful to be taken every half hour until respiration was produced.

I called in two hours ; found the pulse down to 84 ; the patient was in a general perspiration. She recovered without any other remedy in two days. (Dr. Henry, Phila. your, of Hovi,, vol. i., p. 182.)

EXANTHEMATOUS GROUP.

We have tingling and pricking in the skin, itching in different localities, better from rubbing. The remedy may prove useful in

SMALL-POX, when there is high fever, restlessness, excessive pain, and when the functions of the vagus seem much excited.

MEASLES, when the lungs threaten to become involved, high fever, difficulty of breathing, very quick breathing, nausea and vomiting, convulsions before the appearance of the eruption.

SCARLET FEVER, in the early stage of this disease. Nausea, vomiting, intense fever; hard, bounding pulse, hyperasmia of the brain.

SLEEP AND MENTAL GROUPS.

Slept well, but had frightful dreams of being on the water ; rest- less night ; frightful dreams of people drowning ; slept sound. (Burt.) My mind was perfectly calm ; and although I thought it more than probable that I should die, I did not . feel alarmed. (Edwards.)

ACUTE INSANITY — In the New Eng. Med. Gazette, 1871, (page 431,) a case of acute insanity is related. The tincture of this drug cured the patient. The following symptoms were present : Loquacity with exaltation of ideas, or an exalted opinion of her own ideas and powers ; everything seems clear to her ; what had formerly been mysterious to her, she now clearly understands. She does not

ZIISTCUM METALLICUM. 889

want any medicine that will restore her to her former condition. Some of the time she talks and laughs. On some days the laughter is quite constant. One day she talks a long time about one thing, and again changes that theme to some other.

Will persist in con- tinuing to talk, without giving any attention to what iz said to her. Will not answer questions ; does not like to be disturbed while she is talking. She knows all that is going on about the house, and does not want anything said which she cannot hear. Does not want to get up long enough to have the clothes changed.

Head feels bad. The eyes are red, but vision is not affected ; appetite capricious ; not much thirst ; pulse small and frequent. Hyoscya- mus, stramonium, veratrum album and hepar had been given in vain.

PUERPERAL MANIA has been cured with veratrum. A patient of Dr. Atlee was stubbornly silent, suspicious and distrustful of those about her. She thought the physician had poisoned her, meditating her destruction.