Veratrinum

Volume IV — Main text

VeratriniUIl> an alkaloid found in root of V. album, and also in seeds of SabadiUa. CgjHjjNjOg.

1. Provings. — 1. EscHE took ^ gr. of acetate. It produced collapse, with pale, cold, wet skin, pinched features, rapid, thready, irreguUr pulse, violent vomitings, and marked muscular tremblings. (H. C. Wood, op. cit.)

IL Poisonings. — I, In human beings ^ gr. twice a d peculiar feeling in stomach, which after larger doses increaset burning \ there is often salivation, nausea, vomiting, colic, diarrhoea, sometimes urinary tenesmus, perspiration. Used externally, especially on parts affected with rheumatism or neuralgia, coldness, beat, prickling and shooting, and when its use is continued, dull pains ia back, shooting as from electricity in various muscles and joints. U from i to I gr. dissolved in spirit or mixed with togr. of lara is rubbed in for lo to 15 m., or in chronic cases 2 to 10 gr. in i oz. spirit, it causes immediately heat, burning, prickling from the place of application to various parts of skin, when it suddenly ceases to appear on other parts. Occasionally radiating in electric streams through the nervet^ sometimes like boiling water streaming down over back. Also slighc twitchings in various muscles. When rubbed in on face or shouldeo^ especially in hysterical or hypochondriacal persons, violent blows or tearing pains thence to crown. When rubbed in on back, electrical streams to the nerve plexuses of abdomen, breasts and heart, the beats of which are manifestly diminished. When rubbed in on sacrum, spasmodic movements of bladder with discharge of watery urine. AH these symptoms cease after 10 to 15 m., but recur. The skin i» generally unalteredj but if energetically rubbed in, in febrile diseases of on delicate skin, with a tendency to erysipelas or eczema, there are apt to occur inflammatory redness and very violent pain, sometimes pustulil eruptions. (Szerlezk.1, Otst. Zeit.f. Horn.., iv, 452.)

1. a. After a patient has taken 2 or 3 times ^ — ^ gr. of V., often, indeed, 30 — 60 m. after first dose, there arises a feeling of tingling, sparkling, prickling in parts remote from stomach, most commonly in points of fingers and toes, sometimes in elbows, bends of knees ani shoulders, occasionally on forehead or over eyebrows, more rarely and at a longer interval in thighs, abdomen, or back. Simultaneously with this, or soon after, some patients experience a sense of warmth, others of cold, referred to different regions, mostly in hands and soles of feet, knees, and mouth. While one has feeling as if a stream of warm air or drop} of hot water were issuing from these parts, another perceives as it were a frozen atmosphere around the legs, and particularly the knees, m if cold water was poured upon them. Some compare the sensation in the mouth to that produced by sucking peppermint. Generally the warmth occurs when there is integrity of the vital powers, but abdominal torpor; while old hypochondriacs, and hysterical women with predominant asthenia, experience the cold.*

i. Besides the above sensations, it occasionally happens that a paiO)

• On the other hand, a few doses sufficed to restore permanent warmth to the 1 of a feeble, emaciated, melancholy female, which for year* before had icy cold.

it our have been of long standing, in some part of the body either suddenly disappears altogether or is replaced by another, equally sudden in its invasion, in some distant part. Examples also are not wanting of a limb or of the muscles of the face, especially if previously the seat of painful or spasmodic paroxysms, becoming seized with starting or tremor soon after taking the medicine. (Forcke, in B. and F. M.-Ch. Rev., viii, 363.)

1. V. and its salts, in ^ gr. doses, generally give rise to sensation of warmth in stomach, which gradually extends itself over abdomen ind lower part of chest. After dose has been repeated once or twice, sime feeling is experienced in lower extremities, and particularly in feet upper extremities and head become also affected in same manner, and, if medicine be pushed further, a sense of tingling exactly similar to that caused by local application of V. manifests itself in various puns of body, and sometimes over whole surface ; this is generally accompanied by considerable perspiration and some feeling of oppression; and all these effects are augmented by heat or by use of warm diluents. To this succeeds sensation of coldness ; and should admin- Mtfition be continued, stomach becomes affected, and a degree of nausea takes place, followed by vomiting. In a few instances only have these •"etnedies acted as diuretics, and in still fewer as purgatives. No nar- ^otic effect has been observed to arise from their use. (Tornbull, ■^cnunculactr^ Lond., 1 835, p. 19.)

2. a. A lady afflicted with tic-douloureux swallowed by mistake a *^c»5e of a liniment containing V., amounting to about 3 gr. Dr. Blake ^'^wnd her, 2 — 3 h. afterwards, complaining of great giddiness, sickness, 5irst, relaxation of bowels with tenesmus, and sensation as if all intes-

A^* *i« were tied together with a strong cord and continually tightened, ^le said she felt dreadfully tired, weak, and faint, as if she had under- ^^Kane some tremendous exertion. Tongue was much swollen, and ^^^outh and throat very sore, as if she had swallowed boiling water ; *~^ ^pil was extremely contracted (there was opium in the liniment), ' veathing hurried, pulse quick and very small ; and there was exces- ^vc feebleness in action of heart. There was sense of constriction in ^uccs, making swallowing difficult. There were continual calls to ^^^icturition, and tingling all over skin, with now and then fits of most ^'-^nbearablc itching indifferent parts of body, compelling her to scratch ^^nd rub vigorously in the most uncontrollable manner.

b. Free emesis was induced, and relieved all the symptoms save

^he pruritus, which worried her terribly all the d., passing off very

'Slowly, and only really ceasing on 3rd d. For at least 2 mos., more-

K)vcr, skin was seat of an exceedingly troublesome tingling, as if she

liad been stung by nettles, but without any rash or other appearance

«f irritation. Also, for some time after, when she was eating, or

laughing heartily, or talking with animation, there would frequently

be a spasmodic closure of the lower jaw, which would shut suddenly

with a loud snap. {St. Geo. Hosp. Reports., v, 69.)

1. A gentleman took by mistake in a glass of hot ale and ginger (a timilar glass having been previously imbibed) a liniment containing

• Dr. Tumbuir* veracria was made from Sabadliia. — Eds.

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29 gr. of V. Almost immediately afterward? he experienced a peculiit sensation of oppression and anxiety in the headland a sense of suiFoation. Discovering his mistake, he sought medical aid at once, and free emesis was induced. In about } h. after vomiting, very violent sneezing came on, and continued for about I h. Patient then slept, and had no disagreeable symptoms afterwards. {Pharm. 'Journ.^ x, 521.)

1. Ebers's observations were made on patients of various sorts. He says : I have never noticed that the sensorium was in any way affected more when the drug was applied near the nerves of the head; but, on the other hand, when it is applied even in small doses to the scrob. cordis it causes sensible effects in the spinal cord and the nerves proceeding from it, on the nerves of the thorax and of the abdomen. The pain extending through the whole periphery of the nerves of the abdominal walls, drawing along the spine, twitchings, great anxiety, orthopnoea, nausea and vomiting, and a feeling which the patients knew not how to describe, but which they said was intolerable, and they begged urgently to be relieved of this torture. Its internal use caused severe nausea, inclination to vomit, anxiety, vertigo, and complete anorexia. The rubbing in of V. anywhere caused great diureiil. {Casper's JVechemch.^ ^835, 790.)

III. Experiments OH animais. — I. EscHE made a number of experiments on dogs, cats, rabbits, and birds with V. He observed : a few m. after administration of the drug the animal became very restless and anxious, much saliva flowed from the mouth, the heart's beats became irregular, slow and intermitting, the respiration deep and slow. The animal loathes its food, and is tormented by violent efforts to vomit, which sometimes amount to actual vomiting of what has been eaten i there is rumbling in abdomen, which is either spasmodically contracted or distended and soft ; sometimes violent diarrhoea ensues, vomiting viscid mucus, or a gelatinous and even bloody fluid. The evacuii is caused by violent and strong contractions of abdominal muscles, wh continue for some time after the evacuation. The respirations become gradually slower and slower. The animal shows anxiety and restle«> ness, with staring dull eyes. The voluntary muscles become vcrr weak, the head always heavier^ and the animal falls down and is unable to rise again. The external surface of the body is cool, there are spasmodic contractions of pharynx and other convulsive affections especially in the lower extremities and facial muscles, but the cercbr*! functions are not impaired. If the dose was not too large, heildi returns after copious discharge of fa;ces and urine with sediment, the skin becomes warmer, the convulsions cease, and the animal regiini power in the voluntary muscles j but the loathing of food, the weakness and slow pulse continue for some time. If the dose were stronger, then the nervous life becomes depressed, there is apathy and general atony, the respirations and circulation are gradually extinguished, the convulsions become tetanic, and the animal dies. But even then the animal is sometimes saved by constant evacuations. P.M. examtiu* tion shows the lungs blackish in colour and filled with blood, they crepitate less and often sink in water. The cavities of the heart and the large vessels are filled with black coagulated blood. The liver is

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H>ngested, the gall-ducts and bladder are filled with bile, tongue and buccal cavity dry and pale, cesophagus and sometimes stomach also very contracted, but there is never inflammation of stomach, it contains either remains of food and a watery acid fluid or much bile and mucus. The intestinal canal is very contracted, and its m. m. in folds ■nd much reddened ; it contains much bile and mucus. The bladder Bppears to be spasmodically contracted. Nothing abnormal in head except some venous congestion. {De Veratria effectibus — quoted by TOD Praag.)

a. Von Praag made a number of experiments on dogs, rabbits, and frogs. His conclusions are that when the alkaloid is administered the respiration and circulation are diminished in intensity, the muscles lose their tension, the irritability of many nerves (especially the peripheric cutaneous nerves) is diminished. On the other hand, very small doses cauise vomiting and frequently diarrhcea, but diarrhoea follows more frequently large doses. The urinary secretion is sensibly increased, so also is the saliva. The stage of excitement is shown by hurried breathing, quickened pulse, spasmodic tension of muscles, increased nerrous irritability. Death seems to ensue from paralysis of spinal cord. {Virchow's Archiv^ vii, 286.)