Apocynum cannabinum

Volume I — Special Symptomatology

(Indian Hemp.)

This should not be confounded with A Androsemifolium. The medical properties of the two are widely different.

Botanical Description. — It is a perennial plant, stems herbaceous, erect, branching, of a brown color, and two or three feet in height; the leaves are opposite, ovate, oblong, acute at both ends, and somewhat downy beneath; the cymes are pedunculate, many-flowered and pubescent; the corolla is small and greenish, with a tube not longer than the calyx, and with an erect border. The pod, or follicle is from three to five inches long, and resembles the pods of the Asclepias syriaca, or common silk weed, but are much smaller.

The stalk and root abounds in a milky juice which concretes into a sub stance closely resembling caoutchouc. It is the juice which contains the active principles.

The root, which is the officinal part, is horizontal, five or six feet in length, about one-third of an inch thick, dividing near the end into branches, which terminate abruptly, of a yellowish brown color when 3-oung, but dark chestnut when old, of a strong odor, and a nauseous, somewhat acrid, and a permanently bitter taste.

It grows in damp places, by marshes and running streams, and is indigenous to nearly every part of the United States.

Officinal Preparations. — Tincture of the root, made by maceration with dilute alcohol. Triturations of the root.

(The tincture should be dark red, or light brown, and of an intensely bitter taste. I have used a tincture made with Spirit. Nitri dulc., with most excellent effects. The tincture and its dilutions seem to affect the urinary organs, but are not as efficacious in Dropsy, etc. An infusion of one ounce of the fresh root in one quart of water, has been successfully administered and seems to act more promptly in dropsy in teaspoonful doses than any other preparation. The trituration seems to be most efficacious in affections of pulmonary organs.)

From the fact that in many cases, particularly in dropsical effusions, the most powerful, as well as the most speedy and certain effects, have been obtained from the decoction, and that Hunt's decoction seemed to answer the purpose better than any other preparation ever proposed. It may be

procured through Boericke & Tafel. This formula, which is almost the same as Hunt's, and which will act equally well: Take of the fresh root one part, by weight, add nine parts, by fluid measure, of boiling water, allow to stand six or eight hours, then add one part alcohol, allow to stand six or eight hours more, when it may be filtered and kept as a permanent decoction. Dilutions may be made from this, the first and second, using part water, the third, and higher, all alcohol.

Sphere of Action. — Mucous surfaces, serous membranes, skin and kidneys; causing increased secretion and elimination (primary,) followed by the opposite condition, (secondary.)

Analogues— Asclepias tuberosa and 8yriacay Eupatorium purpureum, Helleborus niger, Kali-hydrojod, Benzoate of ammonia.

Head.

Heavy, stupid headache, with drowsiness.

° Hydrocephalus acutus, in children, (third stage.)

Eyes.

Heat, with redness and irritation, as if several sharp grains of sand were in the eyes.

Nose.

Nostrils and throat filled with thick yellow mucus.

• Coryza; first dryness, then thin, irritating watery discharge,

followed by discharge of thick mucus. ° Infantile coryza, 'k snuffles."

Mouth and Tongue. Dryness, with nausea and thirst.

Throat.

Throat filled with thick, well concreted yellow mucus in the morning.

Unpleasant degree of heat in the throat.

Stomach.

Distension of the stomach and bowels after very light meals. ° Sinking at the stomach, with profuse urine and nausea. Violent vomiting, with prostration and drowsiness.

• Increases the appetite and digestion.

° Irritable stomach, so bad that the patient could not retain even a draught of water, in dropsy.

Abdomen.

Decided distension of the abdomen, especially after a moderate dinner.

The upper bowels seem distended, — the lower not at all. Occasional flatulence, with uneasy sensations of the bowels.

''Ascites — many cases, from a variety of causes.

Stools.

Loose but not very copious bilious stools.

• Evacuations very scanty. Watery diarrhoea.

Kidneys and Urine.

Primary.

• Dull, aching pain in the region of the kidneys, with increased

secretion of straw-colored urine. Very profuse light-colored urine; several quarts were passed

every day. No sediment in the urine.

Secondary.

• Decided scantiness of urine, with slight dyspnoea. Urine diminished to about one-third the usual amount. Scanty urine, with little expulsive power in the bladder.

• Very peculiar torpid action of the kidneys. Urine of a light golden, sherry yellow color.

° Dropsy, complicated with chronic diarrhoea.

• Difficult and painful urination, from catarrh of the bladder,

disease of the prostate, or morbid irritability. (F'religh.) 0 Retention of urine, with paralysis of the lower extremities. ° Diabetes insipidus.

0 Dropsy, general or local, and from various causes, but chiefly from lack of eliminating power of the kidneys. {Hale.)

In cases of acute idiopathic dropsies, use the dilutions, beginning with the highest, and descending more or less rapidly according to the progress of the disease. {Ib.)

In chronic or atonic dropsies (secondary,) use the tincture, or if neccessary, the decoction, in one or two drachm doses. (Ib.) Sexual Organs.

° Uterine hemorrhage with great irritability of the stomach and vomiting; syncope and failure of the pulse when moved; blood expelled in large clots, sometimes florid. (Dr. Marsden.)

0 Amenorrhoea in young girls with bloating of the abdomen and extremities, (db.)

Larynx, Bronchi and Chest.

Unpleasant sensation of heat about the fauces and larynx.

Irresistible disposition to sigh.

Short, dry cough, and scanty expectoration of white mucus in

the morning. Oppression of the chest on waking. Sense of oppression about epigastrium and chest. It was difficult to breathe enough at times. 0 Loose, rattling cough, with oppression of the chest, (p.) ° Short, dry cough, with scanty expectoration, (s.) 0 Hydrothorax and hydropericardium. (f) 0 Haemoptysis. (?)

Back and Extremities.

Unusual heaviness of the head, with dull, aching pains in the

small of the back and limbs. No tenderness of the region of the kidneys on pressure, but a

slight soreness of the parts when bringing the muscles

into action, thus indicating the muscles as the seat of the

pains.

Hard aching was felt several times in both knees, sufficiently severe to make me fear that an attack of inflammatory rheumatism was coming on.

° (Edema of the feet and ankles, remaining after typhus, or in dropsy. (Hale.)

Volume II — Special Therapeutics

This should not be confounded with the India hemp (Cannabis indica), a drug which has little or no analogy to this plant, and belongs to another family.

This is one of those remedies whose sphere of action is very limited, but in that sphere it is of immense importance. Its pathogenetic and curative action appears to be confined almost wholly to the kidneys — all the other symptoms seem to be the result. This action on the kidneys does not seem to go beyond passive congestion, with some irritation of the urinary mucous membrane, for even in the most heroic provings no trace of blood, epithelium, or other abnormal sediment is observable in the urine. Primarily it causes profuse discharges, the secretion being very light-colored. Secondarily it causes a peculiar torpid action of the kidneys, very scanty urine, but no pain or renal tenderness. I do not doubt but it could cause vesical and urethral pain, for it has cured such conditions.

This medicine had a reputation for the cure of dropsy in the early history of this country, and has retained that reputation in all systems of practice. Homceopathists have made many brilliant cures where they have used it rationally.

Dropsy , in its various forms, is the chief curative sphere of Apocynum c., but renal dropsy is strictly the proper sphere of its action. Other dropsies may be temporarily removed or palliated by its use, but not cured. It is this palliative power which gave it the name, among the early physicians, of the “ vegetable trocar,” meaning that its value was similar to that of tapping.

Anasarca, ascites, oedema of the legs, and even hydrothorax, may all proceed from suspended action of the kidneys, as an idiopathic affection. When this is the case the Indian hemp properly administered will rarely fail to cure if no structural disease of the kidneys exists. I will here repeat the two rules, given by me in “ New Remedies,” as a guide to its administration :

(1.) In cases of acute, idiopathic dropsies use the dilutions, beginning with the high, and descending more or less rapidly, according to the progress of the disease.

(2.) In chronic, atonic, or secondary dropsies, use the tincture, or the decoction in one or two-drachm doses.

The most brilliant cures ever made with the Apoc. c. were made with the infusion or decoction (§j to one quart of hot water) in doses of half a drachm to four drachms. Even in acute dropsies the infusion acts more promptly than the tincture. This infusion can be “ run up” to the third dilution, in water, if that strength is preferred. Like Digitalis, the Apoc. c. is often apparently inert if given in the alcoholic tincture.

There is no variety of dropsy but may be amenable to its palliative, if not its curative, action. Even in dropsy from organic diseases of the heart it will keep down the effusion and allow the heart a chance to regain much of its former strength.

In post-scarlatinal dropsy, or simple, uncomplicated albuminuria, it will often prove promptly curative.

Bright’s disease cannot be cured by this medicine, and rarely by any other, but the dropsy may be kept in check so long as any considerable portion of the kidney is free from organic changes.

Hydrocephalus has doubtless been cured by Apoc. c., if we are to accept the statement of two eminent physicians, one of each school of medicine (see second edition of “ Hew Remedies ”). The symptoms were : (1) “ Sutures of the head opened ; forehead projecting, sight of one eye lost, the other almost ; child lying in a stupor with constant involuntary motion of one arm and leg;” and, (2) “Paralysis of left side, one eye motionless, the other rolling, bowels disturbed, pulse slow.” In the first case drachm doses of a weaker infusion cured. In the second, drop doses of the tincture. I think I have cured two cases with it, while it has failed in a great many ; but in this respect it is no worse than the Hellebore, which has been so highly praised, and so unsuccessful. In addition to its value in dropsy the Apoc. c. has been used successfully in other disorders.

Nasal catarrh has been caused and cured by its use. The catarrhal symptoms are :

“ Peculiar dryness of the mucous membrane of the nose, with a sensation of stiffness, followed by secretion of thick, yellow mucus, preceded in some cases by a thin, irritating discharge.”

For this species of coryza the 2X trit. of the root is snuffed up the nose. The eyes, throat, and bronchia are affected with the same catarrh, which accounts for its popularity in bronchial and asthmatic coughs , for which it is certainly useful, as I have often proved.

Diabetes insipidus is one of the primary conditions caused by this drug, and the characteristic concomitant symptom is :

“ A sense of sinking at the pit of the stomach , with great debility.”

Like all powerful diuretics, the Apoc. c. sometimes proves powerfully emetic and cathartic. In dropsy, when the stomach is very irritable, and vomiting of all drinks is a troublesome symptom, the Apoc. c. often corrects immediately. Dr. Paine recommends it in diarrhoea , intestinal haemorrhage, and cholera infantum, but I have never had any experience with it in such cases.

Uterine haemorrhage has been cured by Apoc. c., according to Dr. Marsden, who gives us the only clinical experience we have of its use in that affection. In one case ( menorrhagia ) the flow was profuse, clotted, and attended by “ great irritability of the stomach,” fainting, etc. In another case the haemorrhage occurred at the change of life, but was checked in a week, after lasting six. Several other cases of long-continued haemorrhage Dr. Marsden reports cured by the Apoc. c. in drop doses of the tincture. In my practice it has appeared to restore the menses when given for dropsical conditions, and Dr. Barnes, of California, reports that he often cures with it amenorrhoea in young girls, when attended with bloating of the abdomen and extremities.

Dr. Lindsay reports his own case of severe haemoptysis, which had resisted the use of Aeon., Ham., China, and Erig., but was promptly checked by Apoc. c. lx, repeated every few minutes. Another physician says he has checked pulmonary haemorrhage in consumptives with it. It would seem from the cures of haemorrhage reported that it acts very similarly to Ipecac, in such cases, and is indicated by very nearly the same symptom, namely, the vomiting, or nausea.