Guarana

Volume I — Special Symptomatology

(Ouarana.)

Description. — Ouarana consists of the seeds (powdered) of a tree or climbing shrub growing in Brazil; these, according to Johnson, in his " Chemistry of Common Life," are used as we do cocoa. They contain an alkaloid said to be identical with that found in tea and coffee (theine). In the Materia Medica of Trusseau and Pideaux is an account of its use in migraine or sick-headache. At one time it attained much popularity in Paris, in the treatment of sick-headache. It has lately been called up by Dr. Wilks, of Guy's Hospital, London. It has been used successfully by Dr. Wood, of Montreal, and Dr. Helmeken, of British Columbia. No

provings have yet been made, and the following observations are given instead.

Officinal Preparations. — Triturations of the seeds; tincture; dilutions.

Analogues. — Agaricus, Coffea, Cypripedium, Coca, Iris versicolor, Pulsatilla, Scutellaria, Thea, Valeriana, etc.

° Sick-headache — If the attacks are frequent (several in a month), a few grains of the powder should be taken every morning, half an hour before the first meal, as a preventive; at the commencement of an attack the same dose may be repeated every quarter or half an hour until relief appears. {Trotisseau.)

0 The most violent attacks of sick-headache will sometimes yield at the end of five or ten minutes, not to return, {lb.)

0 Used by the natives of Brazil to relieve nervousness and weariness, as we use tea or coffee. {Johnson.)

0 Used for the cure and prevention of bowel complaints. {Ib.)

0 Diarrhoea of phthisis. {Gavaelle.)

° Cholera infantum. {Hale.)

° Chlorosis; paralysis; neuralgia. {Ib.)

° Convalescence from prostrating diseases. {Ib.)

0 Rheumatic neuralgia. {See Therapeutics.)

Volume I — Appendix

(Paullinia Sorbilis.) Description. — See page 484 of " Symptomatology."

Head.

Giddiness. Tinnitus aurium. Redness of face. Staring eyes.

Slight irregularity of the pulse. Moisture of the skin.

Delirium. Dulness of hearing. After its use in neuralgic headache phenomena of its poisonous

action may be observed from the appearance of a malaise

more distressing than the headache which has disappeared. Sensation of pricking and cold, extending to the whole cutaneous

surface.

Gayety. Extravagant behavior. Mental hyperesthesia. Intellectual excitement. Unusual humor for continued hard work. Head confused from 9 p.m. until bedtime. Awoke at midnight, and complained of a tightness across the forehead ; fell asleep shortly, and had no return of pain in the head on waking the next morning.

Aggravation from large doses when taken for headache. The pain became almost unbearable, and nearly the whole night he suffered from delirium.

Persistent twitching of the eyelids.

Sleeplessness. ° Sick-headache. ° Hemicrania.

Chest.

Aggravation when taken for asthma. The difficulty of breathing became so great that he was forced to grasp a support and struggle for breath. The face was flushed with blood, then purple and livid, the eyes bright and staring at first, and the struggle for breath almost agonizing.

Heart and Pulse. ^

Diminution of the heart-beats.

General Symptoms.

Unsettled, restless. Unable to work with vigor. Distressing fulness and throbbing in the head, chiefly in the temporal regions, afternoon and evening.

° Rheumatic-neuralgic lumbago.

Volume II — Special Therapeutics

This is comparatively a new medicinal remedy in this country, a small quantity only having been brought from France, and known to but very few practitioners. For several years its valuable properties have been known and appropriated in the principal cities of Brazil, South America, and on the continent of Europe, where it is used in a variety of acute and chronic diseases, as a general popular remedy, and by physicians in regular practice as well.

Dr. Gavrelle, physician to Dom Pedro, employed it very often while in Brazil, and afterwards in France, and considered it a valuable remedy. He found it advantageous in the diarrhoea of ; phthisis , sick headache, 'paralysis, tedious convalescence, and generally as a tonic.

Dr. Ritchie, surgeon in the English navy, says :

It is held to be stomachic and antifebrile, and is used in dysentery, diarrhoea, retention of urine, etc. It stimulates, and at the same time soothes the gastric system of nerves. It is indicated in fever, reduced vital powers, in grief, depression of spirits, colic, flatulence, anorexia, nervous hemicrania.

Severe cases of neuralgia, and diarrhoea with pain, have been most gratefully relieved. Affecting directly the mucous membrane, its application is very general and presents large expectations.

Dr. Macdonald, of Edinburgh, Scotland, has an extended and carefully written communication in “The Practitioner,” published in London, and reprinted in New York, September, 1873, establishing the reputation of Guarana for sick headache. Its effects in neuralgia, sick headache, and diarrhoea are sometimes almost immediate and wonderful.

The term Guarana is derived from the name of a tribe of Indians, who are dispersed between the rivers Parana and Uruguay, by whom it is very commonly used as a condiment or medicine, and also brought into the cities on the coast as an article of commerce.

It is prepared from the seeds of a climbing plant, “ Paullinia sorbilis ” (according to Martius), by the natives. The seeds are

dried, pounded, mixed with tapioca, and with water made into rude cylindrical masses, which, by drying, become very hard.

Johnson, in his “ Chemistry of Common Life,” says the seeds are used as we use cocoa, as a beverage. They contain an alkaloid, said to be identical with “theine,” found in tea and coffee.

In the “Materia Medica ” of Trousseau and Pideaux is an account of its use in migraine. It has lately been called up by Dr. Wilks, of Guy’s Hospital, London. It has been successfully used by Dr. Ward, of Montreal, and Dr. Helmshew. of British Columbia.

It has become a popular remedy with the allopathic school, not only in sick headache, but in colic, diarrhoea, and even in chronic rheumatism and neuralgia.

Its sphere of action appears to be upon the sympathetic nervous system, upon which its primary action is that of a sedative. In this respect it resembles Valerian, Scutellaria, Pulsatilla, Coffea, and perhaps the Bromides. It may be found to resemble Iris and Dioscorea.

I have cured a few cases of sick headache with the powder. It appears to be best suited to those persons who have used tea and coffee to excess, or in whom nervous headaches, followed by vomiting, are excited by any error in diet or depression of mind.

It has been recommended in that unpleasant and uncontrollable sleepiness, drowsiness, and heaviness of the head, with flushed face, which occurs in persons of sedentary habits after eating. If it will remove this symptom it will be a boon to many students and literary men.

Dr. George A. Hall, of Chicago, tested its value in the summer of 1874 in the u summer complaints” of children; in diarrhoea from teething ; in vomiting and diarrhoea from want of proper food ; and he reports that in many cases its use was followed by surprisingly good results. In one case of chronic diarrhoea, nearly to marasmus, it cured the child in a short time. He gave teaspoonful doses of a solution of ten drops of the tincture or fluid extract in half a glass of water, repeating the dose every few hours.

Dr. Scudder, in the “Eclectic Medical Journal,” gives the following candid account of his experience. He says :

I will report two cases showing its non-curative action. Mr. B. had suffered

for years from attacks of most intense headache, of which sickness at the stomach was a common feature. A physician suggested tincture of Guarana, in half teaspoonful doses, every two hours. He procured it and took the dose as ordered. The pain became almost unbearable, and nearly the entire night he suffered from delirium. The experience was so unpleasant that he decided to take no more new remedies.

Mr. A. O. T. has suffered for the past nine years with asthma of the severest form, and has tried almost every remedy suggested for this most obstinate complaint. Having exhausted my remedies, I concluded to try Guarana, as possibly a nerve stimulant would be of advantage.

Of the tincture prepared by H. M. Merrell & Co., I ordered fifteen drops every four hours. Taking the first dose, he went out to the stable, and in probably not more than five minutes the difficulty of breathing became so great that he was forced to grasp the manger and struggle for breath. It passed off in the course of half an hour, but it was the severest paroxysm he had ever experienced. Not thinking that the medicine had anything to do with it, he repeated the dose, which was followed by another bronchial spasm. This was witnessed by the family, and described as most fearful, and from which recovery seemed almost impossible. The face was flushed with blood at first, then became purple and livid, the eyes bright and staring, and the struggle for breath almost agonizing. I need hardly add that the medicine was not repeated.

The Guarana acts upon the nerve-centres, probably upon the brain, spinal cord, and especially upon the sympathetic and its associate cranial nerve — the pneumogastric. Its action is very decidedly stimulant. I have used it in cases of headache, with enfeebled circulation — want of stimulus, with most marked benefit ; and in some other affections characterized by enfeebled innervation, and it is in such cases that I would suggest its trial. The two cases reported were just the opposite, and required sedation instead of stimulation. In the case of Mr. T., the evidence of an irritable and excited nervous system were marked, and giving Guarana simply added fuel to the flames. The case of headache was of the same character — it would probably have been relieved by Gelseminum. I am satisfied, further, that the dose advised is too great, at least of the tincture I have used. Try it in doses of five drops, and repeat, if necessary. It is always well to commence a new medicine with the minimum dose.

In relation to its use in chronic rheumatism , Mr. E. A. Rawson states (“Irish Hospital Gazette/’ April loth, 1874) that when suffering severely from lumbago, and other remedies failing, he tried Guarana as an experiment. He took fifteen grains in hot water with cream and sugar, and experienced entire relief from pain for twenty-four hours. When the lumbago returned, he took another dose, with the same result. He says :

I gradually increased the dose to forty grains, and took it regularly once a day for about a week. The lumbago disappeared. I gave up the Guarana, and in a few days the pain in the back returned. A forty-grain dose removed it, and

it did not return for several days afterwards. Now, -whenever it does, I have my remedy at hand. During the last month I have experimented largely with Guarana, on a variety of patients, rich and poor. The results vary. When the pain is acute, coming on with sharp stings, Guarana acts like magic ; when it is of a dull, aching character, the drug is slow in its action, and several doses must be taken before any decided benefit can be perceived.

I have come to the following conclusions, viz., that whenever the fibrous envelopes of nerves, the aponeurotic sheath of muscles, the fasciae of tendons, are the parts affected, Guarana gives, if not instantaneous, at least very immediate relief, which will last from twelve to twenty-four hours ; and I confidently expect that perseverance in the use of the drug, gradually increasing the dose up to forty grains, will entirely remove any of the above-mentioned kinds of rheumatism.

Of the good effects of Guarana on nervous hemicrania there is no doubt ; and I trust it will prove in other hands as valuable against rheumatism as it has in mine.

You will, all of you, have obstinate cases of nervous disorder where the ordinary remedies fail. In such cases try the Guarana, and report the results.

PASSIFLOEA INGAENATA,

I wish to call your attention to this plant, and quote a paper by Dr. L. Phares, A.M., M.D., of Newtonia, Miss. :

In 1838, while a student, my old friend, the late Dr. W. B. Lindsay, then of Bayou Gros Tete, La., directed my attention to this plant as an unrivalled remedy for tetanus infantum. He used it for thirty years with extraordinary success in all cases of tetanus neonatorum. While resident at Grand Gulf, Miss., he extended its uses, and after his removal to New Orleans he still further enlarged his ideas as to its uses, several times requesting me to prepare and furnish him the medicine. Having no acquaintance with scientific botany, and finding the plant differed much in strength in different samples, he naturally fell into the error of supposing that the difference resulted from using five or six species. He was finally convinced, however, that he had never used but one species, and that the difference in strength was caused by difference in locality of growth, season of gathering, mode of preparing, etc. As found on the dikes or levees around New Orleans, “ it grows luxuriantly, but has no virtues at all.” That grown on uplands is much better, and that gathered on “ Bayou Gros Tete seems to be stronger.” Last year, a few weeks before his death, he wrote in answer to an inquiry which I had made: “I have much to say — I am satisfied it is no narcotic. It never stupefies or overpowers the senses. A patient under its full influence may be wakened up, and he will talk to you as rationally as ever he did ; leave him a moment, and he will soon be off to the Elysian Fields again. I have tried it, my friend, in all sorts of neuralgic affections, and have usually astonished my more enlightened patients with it. Many times I have had them to ask me, what in the world it was that had such a sweet influence over them.” From ob-