Veratrum Album

THE root of the plant is used in medicine. It may be prepared by trituration, or used in the form of a tincture.

It was known to the ancients, and was used by them to cure insanity and various spasmodic affec- tions; and it is recorded of Hippocrates that he cured with it a case much resembling Asiatic chol- era, as follows :

"A young Athenian, affected with cholera, evacuated upward and downward with much suffer- ing; nothing could arrest the vomiting or alvine evacuations. His voice failed; he could not stir from bed; his eyes were lustreless and sunken; he had convulsions of the lower extremities from the abdomen downward; he had hiccough, and the alvine dejections were more copious than the vomitings. He took Veratrum in lentil-juice and recovered." This was a most excellent homoeo- pathic prescription.

The action of Veratrum on the vital force is but moderate in so far as the sensorium and the nerves of animal life are concerned, but in so far

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as the system of nutrition is concerned it is most profound. The entire system of vegetation is affected in such a way, and to such a degree, that it seems as though the body were in a great measure withdrawn from the control of the vital forces, and given over to the action of mechanical and chemical laws.

The blood tends to separate into its proximate' constituents, as it would do if suddenly withdrawn from the body; the liquid constituents seem to filtrate in a half-mechanical manner through the tissues, and thus we have a copious cold, clammy sweat; copious serous vomitings and diarrhoeas; evacuations that are astounding from their quantity and from the mechanical manner of their ejection; the stomach seeming to become completely filled, and to be emptied by a sudden convulsive effort provoked by its complete distention..

This, then, is the key to the pathological char- acter of the Veratrum disease — torpor of the vegetative system, with comparatively slight affec- tion of the system of animal life.

As might be inferred from the above, the fever of Veratrum is characterized by predominant and sometimes exclusive coldness. The sweat is cold and clammy, and it is notably characteristic that almost every important symptom of Veratrum, wherever produced, is accompanied by cold sweat of the forehead.

As a matter of course, among the symptoms of Veratrum great weakness occurs. It is to be

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observed, however, as distinguishing Veratrum from Arsenic, that this weakness is not disproportioned to the other symptoms, is not unexpectedly great, and is not more than might be expected from the symptoms of diarrhoea, vomiting, or general dis- turbance which mark the case. Neither are the symptoms attended by the restlessness, anguish and intolerance of pain which are so characteristic of Arsenic ; nor indeed do the symptoms involve a great amount of pain. That which is felt is philosophically endured. The patient is quiet.

It must not be inferred from what has been said that Veratrum exerts no action whatever upon the sensorium. On the contrary, it produces a kind of mania; and Hahnemann affirms that it is a most precious and indispensable remedy in the treatment of various forms of mania and insanity. Moreover, he found it an indication for Veratrum if various kinds of pain were accompanied, now and then, by a kind of temporary or transient delirium or mania.

The affection of the mind and disposition is as follows : A kind of busy restlessness, a hurried and driven feeling that induces one to undertake a great variety of labor, which, however, he has no heart to finish. Still more common, however, is a gentle melancholy, a disposition to weep, and an inconsolable grief over an imaginary mishap, which cause the patient to sit weeping and not to be comforted, or else to run crying and howling about the apartment. This condition ends in a

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raving mania, with cursing and scolding, endeavors to escape, biting and tearing everything and every- body that offer opposition ; accompanied by fooHsh imaginings.

Veratrum produces vertigo.

The headache is a pressure upon the vertex, generally attended by pain in the stomach. It is noteworthy that this pressing pain of the vertex is relieved by pressing on the vertex with the hand. I know but one other remedy of which the pressing headache in the vertex is thus relieved, viz.: Menyanthes trifoliata. The headache of Men- yanthes is accompanied by icy coldness of the hands and feet.

The pupils contract. The sight becomes weak. Double vision is observed ; and black spots and sparks appear before the eyes.

The eyelids are dry ; the upper lid seems par- alyzed, the patient cannot raise it; ptosis occurs, and has been cured by Veratrum (like Sepia).

The face is cold, the features are distorted, the complexion is cyanotic. The face is covered, par- ticularly the forehead, with a cold, clammy sweat, during the symptoms of the stomach, bowels and chest

The digestive organs are eminently affected by Veratrum.

We notice first an aversion to warm drinks, and a longing for fruit and for acids. The taste is diminished, or there is a feeling of coolness in the mouth, such as peppermint produces.

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Nausea occurs, often with a taste as of bile in the mouth; sometimes it is felt after breakfast and ceases after taking dinner.

The matters vomited are food or green bile, and tenacious mucus ; the vomiting is preceded by a general shudder, and the nausea continues during the intervals between the vomitings. The vomiting prostrates the patient, but not more than the quan- tity and violence would lead one to expect.

Pressure in the epigastrium, extending to the sternal and hypochondriac regions, and down to the OS ileum. Pinching, tensive, cutting pains, as if the intestines were cut with knives, and with this pain diarrhoea is associated.

In the inguinal regions, frequently, a sensation as though a hernia would protrude ; and when coughing, a sticking pain along the inguinal canal. These symptoms have caused a successful use of Veratrum in hernia.

As regards stool, we find two different condi- tions :

1. Constipation, characterized by a disposition to stool in the upper part of the intestinal canal, but an indisposition, sluggishness or apparent inac- tivity of the rectum and lower intestine. It is a most useful remedy in obstinate constipation when Nux vomica has failed to relieve, and especially in the constipation of infants.

2. Diarrhoea, watery, light-colored. Sometimes colorless, very copious.

It is characteristic of the vomiting and diar-

rhoea of Veratrum, but particularly of the vomiting, that they are provoked by taking liquid into the stomach, which is no sooner taken than rejected. This is equally true of cold and warm drinks. Phosphorus, on the other hand, has nausea, relieved by cold drinks : which, however, are vomited as soon as they become warm in the stomach. The gastric symptoms of Veratrum are aggravated by motion.

The vomiting of Tabacum is relieved by eating or drinkino-.

The vomiting and diarrhoea of Veratrum being sudden and copious, are accompanied by exhaustion, cold sweat, a pinched, shriveled and livid aspect of the face and hands, and loss of voice ; but by no great mental or sensorial disturbance, no great depression of spirits or anxiety.

The menses are hastened and increased.

Veratrum produces a catarrhal condition of the nasal membrane, with incessant sneezing and a tickling in the trachea, which extends thence through the bronchi to their extremities. The cough is generally dry, and if so, it is induced by the least motion of the body, or by going from a cold into a warm atmosphere. The opposite of Rumex crispus.

- Sometimes the cough is loose, and it is then accompanied by constriction of the chest.

Sometimes the slightest bodily exertion pro- duces dyspnoea and palpitation.

Pains, stiffness and lassitude in the trunk and back.

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In the extremities, lassitude ; and in the lower extremities a kind of paralysis, as from too long a walk. Besides this, tonic cramps in the calves and thighs.

PRACTICAL APPLICATIONS.

It is useful in intermittent fever, when coldness predominates. The symptoms which call for it are, especially, great weakness and prostration; actual sinking of the forces ; very slow pulse, and the impulse of the heart very weak, during the apyrexia as well as during the paroxysm, but especially during the latter ; cramps in the limbs, and especially in the stomach and abdomen ; paralytic sensations ; syncope ; watery diarrhoea, or obstinate constipation depending on inactivity of the rectum ; collapse ; cyanosis.

The cold stage always predominates, and indeed often overshadows and extinguishes the hot stage. The changes of temperature are most marked in the extremities.

The hot stage often fails entirely, and it never reaches a high grade ; generally it consists rather in a subjective sensation of warmth while the objective temperature is hardly elevated, nay, is sometimes diminished. The pulse is but slightly accelerated ; it becomes somewhat more frequent, but not fuller nor harder.

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The thirst is proportioned to the amount of the excretions.

The sweat is cold and clammy. It comes even before the paroxysm ; lasts until the next. The results of the abuse of Quinine often require Veratrum.

The same general characteristics indicate Vera- trum in typhoid and typhus fevers.

The use of Veratrum in cholera, in diarrhoea, in hernia, in constipation, and in bronchitis, has been alluded to and the indications have been noticed.