Apocynum cannabinum

THE VEGETABLE KINGDOM.

I have now reviewed the majority of the medicines derived from the animal kingdom, and also the most important of those from the nosodes. We next come to the second grand division in natural history, the vegetable kingdom. The vegetable kingdom offers us many varieties of medicinal substances, some of great practical utility and others having but a limited sphere of usefulness. Drugs obtained from this kingdom owe their medicinal effects to the juices which they contain, or to certain properties which reside in the roots, in the flowers, or in the seeds. You may obtain the medicinal qualities of a plant from various parts of it, and these qualities may vary with the part. It is said, for instance, of Belladonna that one part of the plant gives us more of the acrid qualities of the drug, while another gives more of the narcotic properties. We must then be careful in making a proving of vegetable drugs that we are certain of the part of the plant we are using; and in publishing our proving of the same, we should state the part used, or whether it was one alone or all of the parts combined.

A study of the vegetable kingdom involves somewhat that of the mineral, because many of the medicinal properties of the former owe their existence to substances derived from the mineral kingdom contained in the remedy. The principal effects of some of the grasses are the result of the large quantity of Silicea they contain. Ninety-nine one-hundredths of the effects of Laurocerasus come from its Prussic acid. The same may be said of Amygdala persica. Now these substances derived from the mineral kingdom and contained in the vegetable kingdom, become more active than in the mineral kingdom; that is to say, a given chemical, if made in the laboratory, would not present as marked medicinal virtues as the same obtained from a plant. The above remarks also apply to the animal and vegetable kingdoms. Substances existing in the animal kingdom and found also in the vegetable, are far more active in the former. Thus the Colorado potato bug which feeds on potato-plants and derives from thence Solanine, presents more powerfully the symptoms of the latter, than does the Solanine itself.

We shall study the remedies derived from the vegetable kingdom according to the classification of botanists. There are some incongruities in the botany of to-day; for instance, in the leguminous order of plants from which we get peas and beans, from which man may obtain nourishment, is also placed the Lathyrus, which has very poisonous properties Because there is an outward resemblance between the Lathyrus and sweet-pea, it seems not a little incongruous to put them together, when their effects are so opposite.

The five relations of drugs, which I have already mentioned, apply here as in the animal kingdom. There is this to be remembered, that substances having the same origin, generally do not follow each other well. For example, if you have given Ignatia, it is not well to follow with Nux vomica, and vice versa, because they both contain Strychnia. Though they have many symptoms in common, they act too much in the same line. Another example may be noted in Glonoin and wine. When Glonoin was proved, it was found to have a decided action on the pulse. All the symptoms were aggravated when the provers took wine. Wine produces an excitement very similar to that of Glonoin but its action seems to be in the same direction, consequently, it intensifies the effects of the latter.

But the different orders, sub-orders and classes into which botanists divide plants, are so extensive and cover such vague resemblances, that we cannot confine ourselves strictly to this rule, and, taking the drugs in a large order of plants, say that they cannot follow each other well. Take the Ranunculaceae, from which we obtain Pulsatilla, Aconite, Helleborus, and Staphisagria. Now the resemblances between these four drugs are not such that they cannot follow each other without injury. If we find, then, from our study of the symptomatology of the drugs that there are no resemblances between them, the rule does not apply. The rule would not apply to the Anacardiaceae with Anacardium and Rhus tox. These drugs bear a family resemblance, but their points of divergence are so great that one drug may act as an antidote to the other. The rule would apply to Ignatia and Nux vomica, and to Pulsatilla nuttalliana and Pulsatilla pratensis. I will now take up the consideration of the individual drugs derived from the vegetable kingdom.

APOCYNACEAE.

In the order of Apocynaceae are a number of plants which we use as medicines. Among these may be mentioned Apocynum cannabinum, and androsaemifolium, Gelsemium sempervirens, Vinca minor, Oleander, Nux vomica, Ignatia, Woorari, Alstonia scholaris, and Spigelia. By some authorities Gelsemium, Nux vomica, Ignatia, Curare, and Spigelia have been included in another order, the Loganiaceae. This order of plants is very poisonous; they depress the nervous system, causing prostration, and even narcosis and paralysis; and some of them, death.

Apocynum Cannabinum.

Apocynum cannabinum was said by Pliny to be fatal to dogs, and from this circumstance its name was derived. It has a tough fibre, like hemp, which has been used for cordage.

Apocynum cannabinum has a marked effect in increasing the flow of urine. It is not sufficient, however, in the present course, to study the drug simply as a diuretic, because it has such a decided action on the vital forces that it demands an extended notice. It depresses the vital forces greatly, as evidenced in the relaxed sphincters, loss of muscular power, etc. This loss of power is an important general symptom since it qualifies, as we shall see presently, the cardiac, renal and intestinal symptoms.

In the last few years Apocynum has come into very extensive use in the treatment of many forms of dropsy. When I give you a succinct resume of its symptoms, you will see that its indiscriminate use in dropsical conditions is by no means strictly homoeopathic. When not properly indicated symptomatically, it is necessary to exhibit it in large doses. The pods of some of the Leguminosae, and also the Scoparius (broom-corn) cause increased functional activity of the kidneys and so aid in the elimination of the dropsical effusion. But we have to deal with an art that admits of no such prescribing. It aims at definiteness, not generalization. It teaches the selection of a similimum, not of a temporary palliative.

When indicated, Apocynum demands that the following symptoms be present: Bewilderment and heaviness of the head; drowsiness and debility or disturbed restless sleep. The functions are sluggish. The pulse is slow. The bowels are constipated, although the faeces are not hard. The kidneys are torpid, or else the urine is copious and almost involuntary from relaxed sphincters. The nose and throat are filled with thick yellow mucus on awakening. Sense of oppression at the epigastrium and chest, can hardly get breath to speak, even after lighter meals than usual. The patient has a sense of oppression in the chest; he must take frequent deep inspirations. There are also fluttering of the heart, and dartings and prostrated feeling in the cardiac region. The pulse is irregular, intermittent and at times feeble, then slow. The heart beats regularly, then flutters and becomes feeble, then slow and labored, now and then losing a beat. This is just the characteristic group of symptoms we have in cardiac dropsy, and shows what an affinity the drug has for this region. It will often palliate even in fatty degeneration of the heart with dropsy in old people.

Here you may compare several remedies: and first, Arsenicum. This remedy has the same thirst and the same sinking at the epigastrium as has Apocynum, but it is indicated in more advanced cases, and the patient always presents more irritability of fibre.

I showed you the distinctions between Apis, Acetic acid and Apocynum when I lectured on Apis.

Helleborus and Digitalis are similar to Apocynum in causing torpidity, slow pulse, etc. But I think the Apocynum, as a rule, is the preferable remedy as Digitalis often proves to be treacherous.

Apocynum also has some action on the joints, producing a rheumatic condition. The joints feel stiff, especially on moving in the morning.

You will recall, too, that I mentioned Apocynum as a remedy in hydrocephalus; the head is large; there is bulging of the frontal bones; the fontanelles are wide open; there is squinting, and, in extreme cases, the patient is blind; one side is paralyzed. The case much resembles Apis, but lacks the cephalic cry. It is indicated in more advanced cases than Apis. One or two cases have been cured by the continued use of the remedy.

There is a diarrhoea which may call for Apocynum. The stools are copious, yellow, watery, or brownish, and sometimes contain undigested food. They are discharged with an expulsive force like a cork from a bottle. The sphincter ani is so weak that stools escape unbidden or while the patient is passing flatus. After stool, he feels weak or has an " all-gone feeling " in the abdomen. The face is pale and covered with a cold sweat.

Aloes has a similar weakening effect on the sphincter ani, and the great prostration after stool; but the stools under this remedy contain a jelly-like mucus, and there is a colic which is relieved by bending double.

Gamboge has stool preceded by excessive cutting about the navel.

The stool is expelled "all at once" after considerable urging, and is followed by feeling of great relief.

Apocynum also has haemorrhoids, which are associated with a feeling as if a wedge was being hammered into the anus.