Ailanthus glandulosa

Volume I — Special Symptomatology

(Tree of Heaven.)

The Ailantus (not Ailanthus, as many of our prominent physicians and authors spell it) belongs to the natural System Xanthoxylaceae and to the Linnaean system, Monoecia Polygamia.

Derivations. — The word Ailantus was given to this genus by Desfontaine, who formed it from the Molucca name Ailanti. For a long time this tree was considered as a species of Rhus, whence the French name, Verne; Angikor Angikait is said, signifies the Tree of Heaven; hence the American name, and the German name of Gcetterbaum, "Tree of the Gods."

Description. — The Ailantus Glandulosa is a deciduous tree of the first rank, growing to the height of sixty feet and upwards. Its straight, erect, column-like trunk, from two to three feet in diameter, its gigantic boughs and shoots, clothed with large pendulous leaves, give it a noble appearance, and seem to justify the appellation — Tree of Heaven. The leaves are from one-and-a-half to six feet in length, pinnated, with an odd one and having leaflets with coarse glandulous teeth near the base.

On the first approach of frost, the leaves begin to fall, without having previously shown much change of color, displaying 'n this respect, a striking difference from the leaves of most species of Rhus, to which those of this tree bear a general resemblance.

The flowers, which appear in June and July, occur in rather large compact panicles, of a whitish-green color, and exhale a disagreeable odor.

The keys, or fruit, resemble those of the Ash, but are much smaller and more numerous. In some years the tree is said to bear only male flowers ; and L'Heritie states that only twice in ten years it bore male and female blossoms at the same time, in France. In his time it had produced fruit in the Jarden des Plantes, at Paris, and in the botanic garden at Le}-den ; but in both cases it was immature. It has since, however, produced perfect fruit, from which plants have been raised. It has also ripened seeds at White King's, near Reading, in England. At Philadelphia and New York, the seeds of the tree ripen fully in October, and plants are raised from them in abundance.

The Ailantus is not now grown as extensively as formerly as an ornamental tree in the United States. The odor of the flowers is extremely offensive to most persons; this, together with a belief that the emanations of its flowers is injurious to health, has created a prejudice against it. In some places epidemics of cholera and other unusual disorders have occurred during its flowering. In Washington City and Philadelphia hundreds of fine trees have been cut down in deference to this prejudice. I believe that Drs. Hering and Wells reported some cases of poisoning of children from exposure to the volatile poison of its flowers. Hale.

Officinal Preparations. — Tincture with strong alcohol from the fresh well developed flowers, and of the fresh bark of the young shoots and roots, in equal parts. Tincture of dry bark of branches and roots and of the ripe seeds in equal parts, with dilute alcohol.

Analogues. — uffthusa, Agaricus, Arum tri, Arsenicum, Belladona, Baptisia, Hyoscymus, Lachesis, Phosphorus, Rhus [tox. rad. and ver.] Stramo nium, Solanum, Veratrum alb.

Mind.

Continual sighing, with depression of spirits. Stoical indifference to whatever happens. .Restlessness, with great anxiety.

Inability to concentrate mental effort; compelled to read a subject several times to get even a misty understanding of it.

Confusion of intellect; found it almost impossible to add columns of figures correctly ; had to go over it several times to get it right.

Loss of memory.

Mental alienation.

Head.

Vertigo, especially when stooping. Dizziness and confusion of the head. Staggering dizziness when rising or moving.

A sensation of giddiness with nausea and sickness at the stomach.

Tottering gait, with an inclination to stagger, requires extra effort to walk straight.

Giddiness, nausea, with retching and some vomiting.

Slight headache, accompanied with nausea and giddiness.

The figures on the ledger began to dance up and down the columns, my head grew dizzy.

Pain in the occiput, with dizziness and ringing pain in the forehead.

A fullness and somewhat of an intoxicated sensation in the brain.

A fullnes" and burning on the brain. Apoplectic fullness of the head.

Thick, heavy feeling in the head, figures and letters look blurred.

Electrical thrill starting from the brain and extending to the extremities.

Feeling as if an electrical current were passing through the

left side of the head. Headache with confusion of intellect.

Dull heavy headache with heavy feeling in the sternal region,

and burning in the eyes. Heaviness of head with pain over the eyes; ameliorated by

pressure.

Dull compressed feeling with confusion and pain in the forehead.

Pain in center of the forehead, more to the left.

A peculiar, heavy dull pressing pain in the forehead, of no great severity, but which indisposes to or even incapacitates for intellectual labor. This is always relieved by Aloes, 200th.

Between one and two p. m., a heavy frontal headache with

drowsiness; slept two hours. Severe darting pain through the temples and back part of the

head, with confusion of ideas. Severe pain through the temples on waking. Tender, bruised feeling over parieto-frontal sutures.

Pain in the occiput, with dizziness and ringing pain in the forehead, and swelling in the left side of the face, below the eye, and upon the cheek.

Severe pains in the head with chills followed by flushings of heat.

Tingling sensation of left arm and hand, with dull headache, no appetite, tongue coated, pasty taste (on waking in a. m.)

Pain in back, head, neck, and numbness extending from under the left scapula in a band down to the left hip. Eyes.

Eyes feel rough and irritated as from wind and dust. Burning and smarting and aching as from powerful astringents. Sneezed and experienced a sensation of cold about the eyes,

and a gnawing in the chest. Light affects the eyes; intolerance of light. Figures and letters look blurred. Lachrymation in the open air, or by brilliant light. Purulent discharge with agglutinated lids in the morning. Conjunctivitis, with redness and inflammation extending

around the external canthus. Falling out of the eyebrows. ° Chronic gonorrhoeal ophthalmia.

° Eyes suffused and congested; startled look when roused; pupils dilated and sluggish; in scarlet fever. {Dr. Chalmers^)

Nose.

Itching and uneasy feeling around the nose. Soreness and pain on left side of the nose. Catarrhal obstruction, as from cold in the head. Loss of smell.

c Chronic catarrh, discharge thin, watery and excoriating. ° Copious thin ichorous discharge without fetor; discharge of blood and pus. In scarlet fever. {Dr. Chalmers.) Face.

Dusky bilious complexion.

Complexion sallow and inactive; dark blue circle around the eyes.

Irregular spots of capillary congestion, as in the face of a

drunkard after a debauch. Hot, red face.

• Miliary rash more profuse on the face and forehead — especially the forehead — than upon the rest of the body.

Pain in the occiput with dizziness and ringing pain in the forehead, and swelling in the left side of the face, soreness and pain on the left side of the nose, puffed erysipelatous face, feels heavy and sleepy, nausea coming on at intervals

On the second evening tearing in the upper and lower teeth of the left side, also in the face and head, aggravated by lying down and forcing him to walk about. External pressure relieves. Improvement only toward morning. Tongue.

Tongue coated, pasty taste, in morning.

Tongue thickly covered with a whitish coat, brown in centei ° Tongue dry, parched and cracked; moist, and covered with white fur, tip and edges livid. Under the favorable action of Ailantus the clearing off of the coating revealed prominent papillse. In scarlet fever. (Dr. Chalmers.) Throat.

Sensation as after applying an astringent to the pharynx.

Thick, cedematous, and dry choky feeling in the throat, continuing in the acute form only a short time and then becoming chronic.

A fullness in the throat just above the sternum, and a desire to hawk up something.

Throat dry, rough and scrapy; more so in the morning.

Irritability of the throat and hawking up of mucus.

She hawks up greenish puruloid matter from the throat.

Constant hawking and efforts to raise lumps of whitish and yellow matter.

Great accumulation of matter, part of which is easily expectorated, while a portion is with much exertion detached in small flakes.

Croupy choking.

Throat tender, sore on swallowing or on the admission of air. When deglutition is painful the pain always extends to the ears.

Redness of the throat with or without pain during deglutition.

The fauces and tonsils are inflamed with spots of incipient ulceration.

Shedding ulcers, feeling as after the application of Nitrate of Silver.

Tenderness and enlargement of the parotid and thyroid glands.

Thickened and swollen feeling of the muscles of the neck.

0 The throat is livid and swollen, the tonsils studded with numerous deep, angry-looking ulcerations, from which a scanty foetid discharge exudes; the neck is very tender and swollen. 0 The tonsils are prominent and studded with ulcerated points. In scarlet fever. {Dr. Chalmers.) Nausea.

Every morning nausea, and during the day a febrile heat.

With this nausea (but frequently without it,) a diarrhoea

set in, four or five stools daily, with pains in the abdomen

Sometimes vomiting with the diarrhoea. With the nausea an oppression and pain below the hypochon

dria; in some like a stricture below the short ribs. Some

find this symptom very debilitating. Excessive nausea, but no vomiting, during the headache. In women nausea similar to that of pregnancy. Nausea and sickness at the stomach, with sour eructations;

nausea and vomiting. Any food taken was speedily vomited.

Appetite.

No feeling of hunger, but eats his usual quantity. No appetite for dinner, everything tasting flat and insipid. She could take no food; the sight of it made her feel worse. Appetite capricious; or complete loss of appetite. Loss of appetite, slight nausea, disgust at food. During the chill there was great hunger, with a distressing, sense of general emptiness.

Stomach.

Peculiar feeling of emptiness in the stomach. Inactive condition of the stomach, as though its contractive' power was impaired.

Water tastes brackish and flat; no desire for drinks except when eating.

Took a teaspoonful of the tincture. Tn half an hour began to feel queer and somewhat frightened — a sensation of giddiness, with nausea and sickness at the stomach, came over me; cold perspiration stood out upon the skin; my fingers, in fact my whole body, began to tingle and prick; my limbs felt as if they were asleep; the figures on the ledger began to dance up and down; my head grew dizzy; I staggered back and fell into my chair almost unconscious. Drank half a tumbler of Bourbon; soon began to vomit and purge, and was very ill for two hours. Two days after was as well as common, excepting some headache and a sort of numbness of the left arm. Abdomen and Stool.

Tympanitis.

Burning in the stomach and bowels.

Weak, burning, uneasy feeling in the bowels, as of approaching diarrhoea.

A feeling of "insecurity," as if he would be attacked with

diarrhoea any minute. Bowels moved easier than natural two or three times a day. Looseness of the bowels appearing more in the large intestine. Colicky and griping pains in the bowels, with rumbling. Frequent watery dejections, which are expelled with great

force.

Morning nausea with diarrhoea, which is sometimes attended with vomiting.

• Dysentery, frequent painful stools, little fcecal matter, much bloody mucus, with very little fever, {llering.)

0 Dysentery; a specific remedy among the Chinese — tested with good results by Dr. Roberts, a navy surgeon. Genitals.

A. sore appeared on the prepuce of the prover which had the exact appearance of an incipient chancre; it dried up and disappeared in a few days after ceasing Ailantus. [This sore and the rash are similar to those which characterize primary syphilis.]

Cough.

Cough somewhat oppressed ; expectoration muco-purulent, free in the morning, sticky and scanty during the day.

Deep, painful, exhausting cough, with asthmatic expansion of the lungs.

Violent fits of coughing before retiring and on rising; she coughs continually until expectoration becomes free, afterwards is comfortable during the day.

° Dry, constant cough, with oppression, burning, and pains in chest. {Dr. Alley.)

0 Whooping cough. {Dr. Alley.)

° Dry, hacking cough — almost constant — attended with tenderness and soreness of the chest (occurring in measles). {Dr. Freligh.)

° Catarrhal cough, attended with dry coryza and heat of the throat and chest. {Dr. Freligh.)

Chest.

Asthmatic oppression in the larger bronchi.

On the second day after suspending the drug, wheezing, asthmatic respiration.

Feeling as though the air-cells were stuck together; inability to completely expand the lungs; can hear the air-cells open (?) as the lungs expand.

Tired feeling in the lungs, rendering it almost an exertion to breathe.

Excessive soreness and tenderness of the lungs, compelling a

suspension of the drug. Soreness of the internal chest, with pain and aching of the

lungs.

Soreness and pain of the lungs increased; severe pains in the head, with chills followed by flushes of heat.

Pain and contracted feeling, especially through the centre of the left lung, sternal edge.

Aching in the anterior portion of the left lung, extending to the posterior.

Pain, as from a small blade, two inches at the left of the lower

portion of the sternum. Heated, burning feeling, as from breathing hot steam or air.

Burning in the right lung, and under the left shoulder. Aching pain directly under the clavicle, sometimes extending to the sternum.

Back.

Soreness in the glands of the neck, with pain under the left shoulder blade.

Intolerable pain in the back of the neck, upper part of the

back, and in the right hip joint. Pain in the head, neck, back, and numbness under left scapula,

extending as a band down to left hip. Constant aching between the shoulders. Aching, pressed feeling of the dorsal vertebra. Shooting, aching pains in the shoulders and hips. Constant sharp pain through the small of the back and hips.

Superior Extremities. Pain in right scapula, deep inside; it prevents motion of the

arm_a similar pain in the right foot prevents walking. Numbness of the left arm, and a sensation as though the

fingers were asleep. Tingling sensation of left arm, hand and fingers on waking in

the morning.

The numbness of left arm and hand, with pain in the shoulder, back, and hips, lasted four or five days after ceasing to take the drug.

Electrical thrill, extending to the ends of the fingers.

Inferior Extremities.

Limbs felt as though they were asleep.

Numbness of the left leg, with tingling, pricking pain in th( foot and toes.

Feeling of uneasiness and aching restlessness in the limbs. Heaviness of the extremities.

Severe pain in left foot, a kind of tension in walking.

Sleep.

Sleep disturbed and unrefreshing. Heavy sleep during the night.

Great sleepiness in the morning or forenoon; sleepiness the whole day; but this is not refreshing.

After drinking a glass of wine great sleepiness, with fullness of the head.

Fever.

Dry, hot skin, especially in the morning, lasting until the middle of the day. [This symptom will coexist with Ailantus pulmonary affections. (S. A. Jones.)

Cold perspiration stood out upon the skin. [This will occur in conjunction with choleraic symptoms rather than as an integer of the Ailantus febrile role, {lb.)

Felt slightly ill on rising in the morning; could take no food; sight of it made her feel worse; was suddenly seized with vomiting; severe headache, dizziness, hot, red face; inability to sit up; rapid, small pulse; drowsy, at the same time very restless; great anxiety. In two hours drowsiness had become insensibility, with constant muttering delirium; did not recognize the members of her family. She was now covered, in patches, with an eruption of miliary rash, all of a dark, almost of a livid, color. The patches between the points of the eruption were of a dingy, dull opaque appearance. The eruption was more profuse on the forehead and face than elsewhere, and especially on the forehead. The pulse was now small, and so rapid as hardly to be counted; the surface had become cold and dry; the livid color of the skin when pressed out returned very slowly ; the whole was a most complete picture of torpor.

The chill was always preceded by a miliary eruption — most copiously developed on the forehead and face. During the chill there was great hunger, with a distressing sense of general emptiness. Any food taken was speedily vomited. Intolerable pain was felt in the back of the neck, the upper part of the back, and the right hip-joint. During the hot stage there was urgent thirst, with delirium, and a strong desire for brandy.

0 Pulse weak, sometimes barely perceptible, very frequent and irregular. In scarlet fever. {Dr. Chalmers.)

' Eruption, dark colored in many instances, and in some

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almost of a violet hue, scanty, patchy, evanescent, and often long delayed. In scarlet fever. {Dr. Chalmers.)

0 Large maculse and bullae, filled with a claret-colored serum In scarlet fever. {Dr. Chalmers.)

° Petechias In scarlet fever. {Dr. Chalmers.)

c The eruption is slow to make its appearance, and never takes on the genuine scarlet color; it remains livid. {Ib.)

Ailanthus produces an eruption which has an exact resemblance to ordinary measles; but is attended by no catarrhal symptoms or other concomitants of that exanthem. {PP. Wells.)

Generalities.

Languor and lassitude on making exertions. Incapability ot standing long at a time.

Tottering gait, with an inclination to stagger; requires extra effort to walk straight.

All asthmatics who are exposed to the odor feel worse during the blossoming period. {Ilering.)

The odor affects women and children more than men, and old people least of all. {Ib.)

If odor gives any indication, Ailantus should prove a good remedy in malignant puerperal fever. {D>.)

Affects the organism in the following order: throat, lungs, eyes, head. {Dr. Alley.) [In one prover this order of evolution is exactly reversed..]

After discontinuing the drug the head, throat and chest symptoms lasted for about twenty-four hours, and then gradually died away.

The numbness of {left) arm and leg, with pain in shoulder, back and hips, continued four or five days.

Two days after taking a teaspoonful of the mother tincture, as well as ever, with the exception of some headache, an l a sort of numbness of the left arm.

The neuralgic pains (facial) force him to walk about.

Aggravation. Evening; at night. [In the nervous sphere.] L.

While lying down. L. [Neuralgic pains.]

Morning. During the day. [Chylo-poietic sphere.] {Herh^ )

Amelioration. Towards morning. L. [Nervous sphere.}

By walking about. L. [Nervous sphere.] By pressure. L. [Nervous sphere.] Side of Body. Left.

Sphere of action. Most marked on the sympathetic system. Evidently on the par vagum. On the right half of the posterior column of the medulla spinalis. On the fifth nerve (through its connexion with the Pneumagastric?) Antidotes.

Aloes. Nux vomica. Bhus tox. Ars. iod.

Volume II — Special Therapeutics

A careful study ot the pathogenetic, and toxical effects of this drug cannot fail to convince one that it is a powerful blood-poison. When we compare drug-effects with diseases, we observe not only a similarity in symptoms, but a marked similarity in pathological effects. For example, the results of poisoning by Arsenic and Veratrum alb. compare closely with the toxic effects of cholera Asiatica. The ultimate effects of Ailantus correspond to that condition and type of disease known as scarlatina maligna. Belladonna does not correspond to this form of the malady, but to the ordinary scarlatina of Sydenham.

It is in the putrid, malignant, and typhoid varieties of scarlet fever that Ailantus is indicated, not only by the symptoms, but the pathological state of the blood and secretions. Like the poison of the above disease, its morbific effects involve the brain and cerebro-spinal centres, and destroy life in the same manner. The eruption is peculiar; it is dark, almost livid, irregular, patchy, of a violet hue, even scaly, covering the whole body, or delayed and irregular in its appearance. In some cases there are large maculae or bullae filled with dark-colored serum. It (the eruption) remains livid — it never takes on the genuine scarlet color. It sometimes takes the form of petechiae. The fever is intense, with pungent heat, a rapid small pulse, hardly to be counted, great thirst, delirium or coma, and heavy, hurried, irregular breathing.

The head is burning hot, with great pain, eyes sparkling, with delirium, or inflamed (conjunctivitis). The nose discharges a copious, thin, sanious fluid, which irritates the skin (Arum, Nit. ac., Ars.), or blood and pus; the tongue is of a livid hue, dry, parched, and cracked ; the throat livid and swollen; tonsils studded with numerous, deep, angry-looking ulcerations, exuding a scanty fetid discharge; the pain when swallowing extends to the ears, and the teeth are covered with sordes. The urine is scanty, and voided unconsciously.

This is certainly a vivid picture of disease, but the Ailantus has in many instances, in my own practice, appeared to dissipate this malignant condition. Drs. P. P. Wells, Small, Chambers, and others have testified in its favor. Other physicians, however, have failed to get curative effects.

Besides this disease the Ailantus has proved curative in congestion of the brain, purulent ophthalmia, conjunctivitis, ozccna, malignant ulcerated sore throat, tonsillitis with ulceration, and bronchitis, with asthmatic oppression, cough oppressed, deep and painful, with muco-purulent expectoration, free in the morning, sticky and scanty during the day, excessive tenderness all over the lungs; feeling as if the air-cells were stuck together; inability to completely expand the lungs, crepitant r files; cough constant, dry, with oppressive, burning, and stitching-aching pains in the chest. As these conditions often occur during the progress of measles and small-pox, as well as scarlatina, this remedy will meet all the indications, not only in the latter disease, but all the eruptive fevers, when they are attended by the unfavorable symptoms above mentioned. In one case of cerebrospinal meningitis I prescribed it with excellent results. The special symptom, in addition to the general condition, which led me to its selection, was “ intolerable pain in the back of the neck, upper part of the back, and the right hip-joint.” Some of the symptoms indicate that we shall find it useful in malignant dysentery and some varieties of enteritis.

Dr. Robert, a French surgeon, communicates a paper to the

“Archives of Naval Medicine,” relating to the use, by the Chinese and Japanese physicians, of the bark of the root of Ailantus in dysentery. They use an infusion of the fresh bark, allowing the patient to drink it until it causes vomiting and fecal stools. Dr. Robert tested its value; he used a tincture of the dried roots and bark in small doses, and found it superior to Mercury, Ipecac., or any other drug. He states that the blood began to decrease in a few days, and improvement soon set in, and continued steadily to convalescence. When we remember that this disease was tropical dysentery, and that dysentery in that hot climate is a far more serious one than in ours, the value of the Ailantus must have been very decidedly shown or Dr. Robert would not have considered it worthy of mention.