Strophanthus hispidus

Volume IV — Main text

STROPHANTHUS.

Strtpkanthus AiipiJut. Nat. Ord., Apotynaeta.

I. ProvtHgs. — 1. We have made four provings of Str. on healthy Ptfsons [i.e. such as, to the best of our knowledge, were free from cardiac OfvascuJir lesions), with the aid of the sphygmograph, with the view "Jf endeavouring to form a personal opinion as to its influence on arterial

»ieD3ion. a. Camillc B— , act. 28. Nov. 26th, 1887,3 tracing was taken of i>i« r. pulse, which was found normal. He then took 15 dr. of a tinct. of Sir., I to 20, in two doses at 2 and 4 p.m. At 9 p.m. trace again taken j rate slower by ^th ; ascending curve unaltered, apex more rounded, descending curve not only more prolonged but slightly convex. The physiological dicrotism had entirely disappeared (/. e. slight increase of pressure). Same doses were given on 27th and 28th. 29th. — No irregularity, but notable inequality of the arterial pulsations^ which were scarcely bounding ; ascending line not only very short but * See also HyQicyaminum, IIT, s,

extremely oblique, and continuous with descending by a curve of vt lengthened radius. /. t., cardiac impulse much enfeebled, while arterial tension is moderately strong ; the explanation of which must be general contraction of the arterioles. 30th. — After these 24 h. of repose, the ' cardiac action has recovered itself, the curve has regained its normal height, while nearly resembling the arc of a circle, with no trace of dicrotism. Frequency of pulse normal. Same dose. Dec. 2nd. — Th^^ curve still more closely resembles the arc of a circle. Intensity <4^B cardiac impulse somewhat augmented. 3rd. — Curve completely altered i^H ascending line nearly vertical, rising to double its original height ; summit very rounded ; descending line still somewhat convex ; slight dicrotism. All this means a rapid fall in arterial tension, with strong impulse of heart. Pulse was somewhat quicker than naturally. The i patient experiencing some degree of malaise, the proving was carried no farther. The quantity of urine fell, after the first two or three d., about one third.

b. Charles P — , aet. 23, had tracing taken at 10 a.m., Nov. 22nd. It was normal, with well-marked dicrotism. He then took tinct. like a. Tracing taken at 9.30 p.m. showed summit of curve more elevated and ascending line quite vertical (augmented cardiac impulse and slightly diminished pressure). Pulse was somewhat slower. 23rd. 8 a.m., tracing normal, save for a visible increase in dicrotism. Tl patient refused to go on, pleading indisposition.

c. F. L — , aet. 15, very vigorous. Tracing taken at lO a.m., Nov. 22nd, was remarkable for a dicrotism not pathological but comparatively enormous, and for a somewhat acute summit. After the usual doses, at 9 p.m. the curve was found a very little higher, ascending line short, summit rounded, descending line very long and bulging ; without trace of dicrotism in most of the pulsations i frequency of pulse less by J^th. 23rd. — Return to normal state, save that cardiac impulse is slightly diminished.

d. Jeanne R — , aet. 11, in good health. Tracing taken at lO a.m. Nov. 24th showed summit of curve a little rounded. The usual doses were taken this d. and the next, but the e. tracings showed no alteration. 26th. — Doses being repeated, at 8.30 p.m. curve was found rounded to a convex plateau, and descending line raised and bulging (slight increase of pressure). Doses were repeated on 27th and 28th. On 29th (no medicine having been taken this d.), summit much raised, ascending line nearly vertical, considerable increase in frequency of pulse. 30th. — Doses repeated. Pressure becoming strong again, and curve resembling the arc of a circle. Dec. 2nd. — Curve continues rounded, but pressure tends to diminish, ascending line being vertical instead of oblique, and frequency of pulse being increased. 3rd. — Same trace, with lowering of force of cardiac impulse. (Piedvache, Bull, de la Soc, M4d. Horn, de France, xxix, 673.)

III. Experiments on animals. — i. The pharmacological action of S. appears to be an extremely simple one. It may, I believe, be described in the few words that it is a muscle poison. However introduced into the body it increases the contractile power of all striped muscles, and renders their contractions more complete and prolonged. In lethal

s

"**ses, it destroys besides the capacity of the muscle to assume the

"***"rnal state of partial flaccidity, and causes the rigidity of contraction

° t>ecome permanent, and to pass into the rigor of death. As a result

^^hc action on muscle, the heart is early and powerfully affected, ,'^e systole is increased, and the contractions slowed by small doses ;

-cl^ heart is paralysed in a condition of rigid contraction by large doses. *^is action is produced if the influence of the cerebro-spinal nervous ^'■^tcm be altogether removed. (Fraser, Brit, Med. Journ.^ 1885, ii,

1. Dr. PiEDVACHE gives the following as the results obtained by He French experimenters, Polaillon and Carville, Gley and Lapique, *-aborde, and Lepine (also Petikan of St. Petersburg) : — Whether the ^rug acts on the ganglionic intra-cardiac apparatus, or directly on the *T\uscular fibre, this at least is certain, that toxic doses cause cardiac paralysis or rather inhibition, for Laborde has shown that when arrest of the heart has been obtained a slight stimulation will set it going again for a time. These phenomena are seen equally in frogs whose cord and medulla have been completely destroyed, and in those whose nervous centres are intact. But if the action of S. on the cerebro-spinal nervous system is quite isolated from that which it exerts on the heart, it is nevertheless indubitable, as shown by convulsions preceded by a remarkable general debility, diminution and then disappearance of reflex function, progressive and general paralysis from centre to periphery. In a feeble dose, the drug does not appreciably modify the arterial pressure in animals. In a somewhat stronger dose it raises it, but not constantly. In still higher dosage, or by continued operation, the pressure falls little by little, and at last sinks abruptly to zero. Frequency of beats is slightly diminished at first, then increased coincidently with the rise in pressure, then slackened again as that falls, and now great irregularity is observed. {Loc. cit.)

Volume IV — Appendix

STROPHANTHUS. (See vol. ip. 189.)

II, 1. Thad occasion to order a small quantity of the tinct, from fone of our principal chemists, and was surprised to hear that the assistant engaged in preparing it was suddenly affected with a severe headache about the junction of the skin and hairy scalp, which gradually spread to the temples; this was accompanied by double Vision succeeded by impaired sight of I. eye, nausea but no actual vomiting, coldness of extremities, and faintness, It was several h. before effects passed off. The manager of the compounding department was similarly affected, but in less degree. (Brit, Med. Pourn, 1887,

i, 217.)