Pulsatilla nuttaliana

Volume I — Special Symptomatology

{American Pulsatilla.)

Botanical Description. — Villous with long silken hairs. Stem erect; in flower, very short; in fruit, eight to twelve inches high. Leaves long stalked, ternately divided, the lateral divisions two-parted, the middle one stalked and three-parted, the segments once or twice-cleft into narrowly linear and acute lobes. Involucres below the stem, lobed like the leaves, sessile sabulately dissected, concave or cup-shaped in position. Sepals five to seven, purplish, spreading, about one inch long, silky outside. Flower single, appearing before the leaves, pale-purple, cup-shaped. Carpels (fruit) 50 to 75, with long plumous tails, one to two inches in length, collected into a roundish head.

Botanical History. — This plant when first discovered by Nuttall, was called by him the Anemone Ludoviciana. It was afterwards called A. pratensis, by Hooker.

Gray, (Genera of plants of U. S.,) gives a minute description, illustrated by a beautiful plate. He calls it the Pulsatilla pratensis. In the later editions of his Botany, he applies the name Pulsatilla Nuttalliana. Wood places it in the genus Anemone, as the A. Nuttalliana. King (Dispensatory) calls it A. Ludoviciana.

Although it is well that the botanist, Nuttall, should be honored, I should prefer the name Pulsatilla Americana as the fittest designation for

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the only species of the genus growing in America. All botanists agree in giving it the common name of Pasque-flower, which is the popular name given the Pulsatilla in Europe, because the blossoms appear at Easter.

Nuttall states that this plant is to be found near the confluence of the Missouri and Platte rivers, and thence west to the Rocky Mountains. It is also met with in considerable abundance in the States of Wisconsin and Minnesota, especially on the dry and sandy bluffs forming the bed of the Mississippi. It has also been found in the most northern counties of the State of Illinois.

Gray says it does not extend down the Mississippi as far as Louisiana, probably no farther than the lower boundary of Iowa. Along the Rocky Mountains, however, it does extend as far southward as latitude 35°, Mr. Fendler having gathered specimens at Santa Fe.

It is a plant of peculiar appearance. The large cup-shaped flowers of a purple hue, appear before the leaves, almost immediately after the melting of the snow has shown that the long aud dreary winter of the north is approaching its close. Hence these blossoms are eagerly sought for as the first offerings of the long desired spring.

The leaves and stalks of the plant are covered with long delicate silken hairs. It is from this appearance that it got the name of " Goslin Flower," which probably originated with children. The odor of the dried plant is rather faint, being slightly camphoraceous, the taste of the dried flowers simply sweetish and herbaceous, that of the leaves being more astringent with very slight acrimony.

The taste and, to some extent, the odor of the fresh plant are both acrid and irritating.

When the seeds are ripe, each one is surmounted by a long silken tail, giving the plant, at a distance, an appearance somewhat similar to the ripe Taraxacum. These seeds, with their comet-like tails, are borne by the winds which sweep over our prairies, to great distances, there to propagate themselves in new situations.

Gray is correct in stating that the American Pulsatilla is more like Pulsatilla Vulgaris, than the Pulsatilla Pratensis of Europe, as will be seen by a comparison given below.

Jahr, in his Pharmacopoeia, gives the following description of the Pulsatilla nigricans, or pratensis used in homoeopathic practice.

" Stems simple, erect, rounded, three to five inches high; leaves radical bipinnatified, downy; flowers solitary, terminal, having folioles of calyx campanulate, bent at the point, the odor of the herb but slightly evident, taste acrid and pungent. The fresh plant contains an acrid and vesicating principle, and furnishes a corrosive oil, as well as a kind of tannin which colors iron green ; in the dry state it is entirely deprived of this acrid quality. Grows in sandy pasture grounds, on hills and declivities, exposed to the sun."

Jahr further says: "We must be careful not to mistake this plant for the common Pulsatilla. (Anemone Pulsatilla)" (Pulsatilla Vulgaris). "This last plant, of which homoeopathy makes no use whatever, only grows on dry

and sterile hills, and flowers in the spring-time alone, whilst the blackcolored Pulsatilla flowers a second time again in the months of August and September. Besides, the Anemone Pulsatilla, is in all its parts, much less downy than the black-colored Pulsatilla: its stem six to twenty-four centremetres high ; flowers of clear violet or pale red, straight and not hanging like those of the black-colored Pulsatilla; seeds surmounted by a long silky tail."

From this it would seem that the American Pulsatilla partook of the character of both the European varieties. Since the following pathogenesis was first published, the American Pulsatilla has been extensively used in this country, and its curative powers have been found equal to the foreign. I find no difference in their qualities. (Hale)

Officinal Preparations. — Tincture of the whole plant; dilutions.

Analogues. — Arnica, Clematis, Cimicifuga, Cyclamen, Euphrasia, Fer rum, Ignatia, Mitchella, Eupatorium purpureum, Platina, Pulsatilla nig.^ Senecio, Sepia.

Mental Sphere.

Gloomy state of mind, with eructations of sour air.

She feels very irritable, "cross," could not bear to be spoken

to; noise vexed her; she felt like weeping at trifling

annoyances. Confusion of mind; impossible to study.

Head.

Hard pain in the upper portion of the forehead, passing to

the back of the head like a wave, affecting the whole brain. Feeling as if a nail were being driven into the brain just

above the left eye, a number of times. Severe frontal headache all night, caused by a sour stomach. Dull, heavy pains in the right temple; frequent, sharp, cutting. Feverish, hot feeling of the head; severe headache; dull, heavy

feeling in the head in the morning. c Migraine — intense pain in one side of head and one eye, with

chilliness; lowness of spirits and vomiting.

Eyes.

Burning, smarting sensation in the eyelids

Agglutination of the lids in the morning.

Neuralgic pains in the eyeballs, while walking in the open air.

Hot feeling of the inside of the lids, in the evening; burning and smarting of the eyelids.

° Catarrhal affections of the eyes, acute and chronic. {Hale.)

° Opacity of the cornea, when the loss of sight was nearly complete. (Miller.)

Ears.

Fluttering noise in the right ear (first symptom of the ear in the proving).

Drawing pains in the ears, from within outward, frequently.

Feeling as if the ears were closed.

° Catarrhal affections of the inner ear. [Hale.)

Face.

Face hot and red at 4 p. m. till bedtime; with cold feet. ° Complexion becomes clear and good (previously rough).

Mouth and Throat. Yellowish coating on the tongue, along the centre. Sensation of a lump in the throat, recurring frequently.

• Slimy coating on tongue, with offensive breath.

Stomach.

• Prickling, burning sensation in the pit of the stomach. Severe cutting pains in the stomach, with feeling of distension

in the abdomen, and dull headache. Sour eructations, with gloominess.

• Intense nausea, without vomiting, all the time.

Distress in the whole epigastrium, with sharp, cutting pain in

the stomach, passing toward the spine. Feeling as if fine needles were being pressed into the stomach.

• "Weak, faint, fluttering sensation in the pit of stomach, even

after eating. ( Wesselhmft.)

• Vomiting of bitter, bilious slime, with chronic cough. (Ib.) ° Indigestion; dyspepsia. Vomiting of pregnancy. (Hale.)

Abdomen.

Drawing, cutting pains in the lower part of the epigastrium, ,

with constant colicky pains in epigastrium, after midnight. Sharp pains in the epigastrium and right hypochondrium. Rumbling in the bowels.

Aching pain in left groin, just above the crest of the ilium, on moving or bending.

Stool.

• Hard, dry, lumpy stools. ( Wesselhceft.)

Mushy stools, succeeded by cutting pains in the epigastrium. Severe cutting pains in the umbilicus, followed by a dark colored stool.

Desire for stool all the afternoon and evening, followed by

dark, lumpy stool. Loose, papescent stools, with chilliness.

• Catarrhal diarrhoea; also from indigestion. {Burt.)

Urine.

Frequent desire to urinate, desire soon passing off. Frequent urination, too profuse/ light colored. Passed a large quantity of " skunky " smelling urine at midnight.

Dark brown sediment; (urate of ammonia). Pain in the kidneys; tenesmus and strangury. Pain in the end of the penis, after urinating.

Generative Organs.

• Female.-- Sharp pains in the uterus, from side to side,

accompanied with chilliness, trembling weakness of the legs, urging to urinate and diarrhoea. Premature and profuse menses.

° Amenorrhoea, with constant chilliness; coldness of the hands and feet ; loss of appetite, sour eructations, melancholy and general malaise. {Hale, Small.)

0 Retarded menses; irregular menses; leucorrhoea.

° Suppression of the menses; several cases. {Small.)

• Male. — Dull distress in the testicles, with drawing pain along

the left spermatic cord to the testicles.

• Sharp, sticking pain in left spermatic cord and testicles. Seminal emission for three consecutive nights.

Cough.

Coughs a good deal.

° Constant loose cough, day and night, with fullness under

the sternum. 0 Chronic dry cough becomes loosened.

Chest.

Sharp, stabbing pain in the left pectoral is -major muscle, followed by burning sensation when the pains occur. ° Aching pain in the pleura or lungs. ( Wesselhmft.)

Back.

Some distress in the lumbar region during a rain storm.

Arms.

The flexor muscles of the arms ache severely, and are stiff.

Frequent drawing, flexing pains in the wrists and fingers.

Stiffness of the fingers, with drawing pain in the left metacarpal bones.

0 Hands hot and dry. {Causland.)

Lower Extremities.

Drawing pains in the left sartorius muscle, when walking.

Sharp, neuralgic pains, passing from the hip joint down to the middle of the thigh, along the course of the ischiatic nerve.

Frequent dull pains in both ankles.

Severe, dull pains in the right knee joint, for two hours in tho morning, while in bed, during a rain storm.

Trembling weakness in the legs, with a sensation of great weariness and heaviness.

° Rheumatic pains, which are wandering.

Restlessness in the feet, with constant desire to move them.

Skin.

Eruption on the back, legs and ankles, of a dark, bluish-red color, with more or less itching during the day, but at night, in a warm bed, the itching is most intolerable.

Eruption stands out prominently from the skin, looking like measles.

• Itching erythema; urticaria (nodules of irregular form,

round, elongated, annular; turning white on scratching, with red base and white skin between).

Fever.

Pale, weak, with a feverish feeling, and great debility. Chilliness over the whole body, with frequent yawning.

• Hands hot and dry.

Face hot and flushed, after four p. m., with dull headache.

Sleep.

Sleep is often disturbed by awaking with headaches or frequent inclination to pass water; seminal emissions occur; but the most troublesome symptom is itching of the skin, the fore part of the night, caused by a species of urticaria or scalp erythema. ( Wesselhaft.)

Volume II — Special Therapeutics

The American Pulsatilla will in time become an important remedy. I believe it will soon be almost universally used instead of the foreign species. In fact, I see no necessity for using the latter while the indigenous species grows in such abundance. You may be interested in its chemical and medical history.

The first mention of this plant in the annals of medicine was by A. AY. Miller, a German pharmaceutist of Philadelphia, who introduced it to the profession in an inaugural essay presented to the Philadelphia College of Pharmacy.

In this essay the writer refers to his brother, Dr. W. H. Miller, of St. Paul, Minnesota, as having used the plant in various diseases. This physician (an allopathist) is probably the first who used it in the United States.

The author of the above-mentioned essay subjected the plant to an exhaustive chemical analysis, all of which may be quite interesting to the scientific chemist, but is not of sufficient importance to the practical physician to be herein detailed.

Mr. Miller used the flowers and herb ; he does not appear to have made use of the root in any of his experiments. We do not find any reason given in his paper for rejecting the root, which, doubtless, possesses the active virtues of the plant in a high degree.

The results of Mr. Miller's experiments, which are of especial interest to us, are, namely —

1. It was found that in the process of drying the flowers lost 85 per cent, in weight, as compared with their weight in the recent state.

2. The active principles of the plant seem to be extracted thoroughly by Alcohol of the strength of 95 per cent.

3. A portion of the peculiar acrid volatile principle, which is one of the most important constituents of the plant, seems to be lost by the process of drying.

4. The same principle, termed by chemists Anemonin, seems to be capable of isolation from the fresh plant, but not from the dry, and is volatile at ordinary temperatures.

yol. xi. — 40

1. In the course of the experiments the substances extracted possessed a very acrid and almost caustic taste. When volatilized they produced a very irritating, pungent, vapor, affecting the eyes and causing sneezing. Also these extracts had a well-marked “ camphoraceous odor.” In the analysis, grape sugar, gum, resin, an alkaloid, and Anemonic acid were found in appreciable quantities.

2. The inorganic constituents of the plant were found to consist of Sulphate of potassa, Carbonate of potassa, Chloride of potassium* Carbonate of lime, Magnesia, and “ a protosalt of Iron.”

The following practical deductions may be drawn from the above experiments : (a.) Tinctures should be made from the fresh plant, if we would retain all its medicinal constituents. (6.) Every precaution should be taken to prevent the escape of the volatile principle, which is doubtless one of the most important, especially in the treatment of irritable conditions of mucous tissues, (c.) In certain cases the vapors of this medicine may be used with advantage as a topical homoeopathic remedy, especially in affections of the respiratory passages and the eyes.

Certain deductions, which may be termed theoretical , may not be amiss in this place. We find among the organic constituents of this plant three at least of our most valuable remedies, namely : Calcarea carbonica, Kali carbonicum, and Ferrum. In the introduction to Rumex crispus in this work we mentioned the presence in that plant of Sulphur, Phosphorus, and Calcarea, and suggested that certain pathogenetic symptoms produced by Rumex, and its curative powers in similar affections, may have been due to the presence of those agents. Ko one who has studied and used the Rumex can fail to see the close similarity in effects.

So with Pulsatilla. It is highly probable that the Pulsatilla nigricans, now in use, contains the same inorganic constituents as the American variety. Who has not noted the close similarity of many of the symptoms of Pulsatilla with that of Calcarea, Kali carbonicum, and Ferrum ? It has been curative in certain intestinal and gastric derangements, in affections of the respiratory passages, and for the chlorotic conditions in which the above trio are also indicated.

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The chemico-physiological portion of our school can readily accept this explanation of the curative powers of Pulsatilla. Even the believer in high dilutions may not reject the theory, for these salts are held in solution in the plant, are given up to the Alcohol, and then conveyed into the circulation of the patient in the dilutions administered.

We have not been able to obtain a chemical analysis of the European Pulsatilla, but there is doubtless such an analysis on record somewhere in the annals of pharmacy.

We are aware that a portion of our school make no account whatever of chemical analyses of plants, contending that the true and only medicinal or remedial principle is dynamic, and a unity. We shall not here discuss the question; the “golden mean” of truth doubtless involves both the dynamic and chemical theories.

Dr. W. H. Miller, of St. Paul, Minnesota, struck with the many points of similitude between this plant and the European Anemone pulsatilla, conceived the supposition that in chemical composition and therapeutical effects they were also closely allied, if not synonymous. He instituted numerous experiments with a view of verifying the latter surmise, and, according to his statements, they proved to be entirely successful. He claims to have established the value of this remedy in many chronic diseases of the eye, particularly cataract, amaurosis, and opacity of the cornea. Very decided advantage was also experienced from its employment in cutaneous eruptions and in secondary syphilis. Dr. Miller says :

These results, in conjunction with the investigation of its chemical constituents, are sufficient to warrant its substitution for the European Anemone pulsatilla, which, though not often administered by regular practitioners, is very frequently resorted to by homoeopaths.

He thus describes his method of using it :

A tea of the dried flowers and herb was sometimes employed, as well as the juice of the fresh plant bruised and expressed, and then either preserved by the addition of one-fourth of its bulk of Alcohol, or evaporated to the consistence of an extract. In preparing the latter, the presence of some volatile acrid principle was clearly manifested by the highly irritating vapors arising from the juice on the application of gentle heat, producing a very painful impression on the eyes of the operator. As the preserved juice had not been subjected to the

deteriorating influence of evaporation, it was supposed to contain the greatest amount of active principle. It was, therefore, most frequently administered, and the most marked effects of the drug were observed to follow from its use.

The above experience coincides with that of Stoerk, who probably used the same variety afterwards proved by Hahnemann. Stoerk prescribed it successfully in amaurosis and other diseases of the eye, in secondary syphilis, and in cutaneous eruptions.

There is no sufficient reason why Jahr and other Continental homoeopathists should banish the Pulsatilla vulgaris so completely from our Materia Medica, for it has been employed by various European and English physicians of the allopathic school for diseases similar to those in which the genuine Pulsatilla has been used successfully. It has even been used with good results in whooping-cough and rheumatism. From certain inquiries which have been made, we are inclined to believe that much of the Tincture of pulsatilla which is used by our school is made from the latter plant, and even from other members of the Anemone family.

Even the various species of the Anemone should not be left unnoticed. Nearly related to the Pulsatilla, they have many medicinal qualities in common. One of them, the Anemone nemoroso, or Wood Anemone, indigenous to this country and Europe, has, according to Wood, “been found a speedy cure in tinea capitis, applied externally to the head.” Also, “that it is said to act as a poison to cattle, producing bloody urine and convulsions.”

The history of American Pulsatilla in homoeopathy is as follows: In May, 1865, I published a brief article in the “ Medical Investigator,” entitled, “ Have we an Indigenous Aconite and Pulsatilla?” in which I gave a botanical description of the American Pulsatilla, and solicited specimens of the plant. This inquiry was responded to by Hr. Douglas, of Milwaukee, who, together with several other physicians, sent me dried and fresh specimens.

On the 15th of May, 1865, in the Illinois State Homoeopathic Medical Society, as Chairman of the Committee on Materia Medica, I read a report, in which I gave a minute description of the plant, and its chemical and medical history up to that time. This

report was published in the “ Investigator ” for June, 1865. I also called the attention of the Western Institute of Homoeopathy to this plant at its annual session in St. Louis, in May, 1865.

On the 20th of June, 1865, Dr. Burt, of Lincoln, Ill., commenced proving the plant. This proving was sent me several months after, and published, with some clinical observations, in the “ United States Medical and Surgical Journal,” January, 1866. A few other provings have been made and their symptoms given in Vol. I.

It has since been used by hundreds of homoeopathic physicians, but the records of its use have not been published. I have, however, gathered from some of my colleagues a few clinical cases illustrative of its curative action.

The standard preparation used should be a tincture of the whole plant, made by adding to the fresh plant an equal weight of 95 per cent. Alcohol, allowing it to stand three weeks, then decant and filter, and put up in glass-stoppered bottles, and keep in a dark, cool place.

Make the dilutions with pure homoeopathic Alcohol, unless such dilutions deposit a sediment, in which case add, drop by drop, distilled water until the precipitate is taken up. If it should be ascertained that a precipitate uniformly deposits upon using strong Alcohol, substitute Alcohol diluted with one-twentieth or onetenth its bulk of distilled water. It is probable that the sediment contains some of the valuable constituents of the plant, and should for this reason be kept in solution. Of late I prefer the tincture trituration.

The symptoms of a drug are not all that you should know of it, especially if such symptoms have been caused by provings made with the attenuations.

You should study its toxic effects, and investigate its method of action, both in health and disease.

I propose, therefore, to call your attention to the physiological effects of Pulsatilla.

Although physicians of the homoeopathic school are very well acquainted with the symptomatology of Pulsatilla nigricans, its pathological or toxical effects are not generally understood — perhaps the least understood of any of the drugs we use.

Hahnemann, in his “ Original Provings,” does not mention or refer to any cases of poisoning by this plant.

Hempel, generally apt to collect cases of poisoning by drugs, does not mention any of Pulsatilla in his works.

Some of the older German writers mention some of the severe effects of this plant, but no cases of fatal poisoning.

Deitz says an overdose of Pulsatilla is apt to cause pain in the stomach, canine hunger, nausea and vomiting, slimy stools, frequent discharge of urine, profuse and offensive sweat, excessive weakness, so that the person was obliged to keep her bed ; outbreak of vesicular eruption on various parts of the body, trembling of the limbs, and peculiar pains in both eyes.

Vogt says that the most marked and constant of its actions are increased flow of urine, and increased secretion of mucus from the nose and air-tubes, and of perspiration.

Sorbenheim says it acts upon the eyes and skin, mucous membranes and urinary organs in quite a specific manner.

Dierbach says it causes offensive perspirations of the feet and armpits, vesicular and pustulated eruptions, profuse flow of urine, and that suppressed piles and menses are apt to reappear under its use ; it is also apt to excite an irritation to cough, repeated sneezing, headache, dizziness, pain, sensitiveness, and dimness of the eyes ; also nausea, vomiting, pains in the stomach and bowels, colic and slimy diarrhoea.

English and French physicians do not give any original ideas relative to the action of Pulsatilla.

American physicians are all silent on this subject, with one notable exception, namely, the late Professor Tully, one of the best medical minds of this century in the allopathic school. Ilis observations are suggestive, and although couched in the antiquated phraseology affected by him, are well worthy our careful study. He says :

Perhaps, the medicinal species of the genus Pulsatilla, which I believe have been reported by some to be narcotic, of a non-sedative and non-stupefying character, may, in fact, be erethistic after the manner of the Aconite. I am inclined to think they are, but I have no certain knowledge on the subject. These articles, in excessive quantities, are certainly capable of producing constitutional irritation, with jactitation ; and I do not doubt, if pushed to a sufficient extent,

they would also occasion rapidly progressive exhaustion of the powers and energies of the nerves of chemical action, nutrition, and reproduction.

I imagine Dr. Tully meant to convey the idea that the Pulsatillas (also the anemones) may cause death by their erethistic (irritant) effect (primary) on the whole nervous system (the spinal cord) ; and cause exhaustion and general paralysis (secondary).

Homoeopathic writers assert that the action of Pulsatilla is almost entirely spent on the skin and mucous membranes, causing profuse discharges of mucus and sweat, and eruptions. But these effects do not by any means include all the pathological actions of the drug.

Pulsatilla has a decided action on the fibrous tissues of the body, also on the nervous system.

The action of Pulsatilla (by which I mean to include the indigenous with the foreign species) may be thus arranged :

ON THE NERVOUS SYSTEM.

Nerves of Motion. — Pulsatilla is not a tetanic irritant like Nux, Ignatia, and others of this group, nor a paralyzing sedative like Gelseminum and its analogues. It causes a state of erethism. This condition does not result in spasm, tonic or clonic, transient jactitation , twitching, tremors, and perversions of the motions of the body being the extent of its action on the motor nerves. Both the indigenous and foreign species cause 11 great weakness, heaviness, and trembling of the limbs.” The foreign species has cured paralysis of the lower limbs, and the indigenous species is indicated in the same condition. The 'primary action of Pulsatilla resembles the secondary action of the so-called “ Nervines,” namely, Asafoetida, Valerian, Scutellaria, and Cypripedium.

The nerves of motion are deprived of their normal tone ; they become irritable, and their action perverted.

Whether Pulsatilla acts directly on the nervous centres, or indirectly, by irritating their periphery, I am not prepared to decide.

Nerves of Sensation. — These nerves are equally irritated and their functions perverted by Pulsatilla, as are the nerves of motion. We thus get abnormal sensations of heat and cold, neuralgia, liypersesthesia, etc.

Ganglionic System. — The action of Pulsatilla on these nerves is, firstly, excessive reflex irritation, followed by a condition bordering on paralysis.

Clinical Observations. — Pulsatilla, in common with some of its analogues, has a specific power to cause those reflex irritations of the nervous system which we so often see in disease. It may induce nausea and vomiting by its action on the uterus ; palpitation of the heart, from this and other causes ; functional affections of the eyes, amaurosis, and the like, from distant irritations ; vertigo, headache, toothache, paralytic sensations in the extremities, etc., all from causes remote from the apparent seat of the disease.

The chlorotic condition which Pulsatilla is capable of causing is not always the result of idiopathic indigestion, but oftener a debilitated and irritated condition of the nerves which govern nutrition ; digestion and assimilation are thus prevented, and we have a chlorosis of a purely trophic nerve origin.

Muscular System. — Its action on this system is never direct, but only through the nerves of motion, or from a metastasis of catarrhal rheumatic poison.

Mucous System. — The Pulsatilla has a distinct and specific action on the mucous membranes, causing intense irritation, followed by more or less profuse discharges of a blennorrhagic or catarrhal nature. Its action rarely goes on to ulceration. If these discharges are prevented, or suddenly arrested, as in natural diseases, the serous and fibrous tissues take on an active inflammation. Thus, a Pulsatilla catarrh may result in a synovitis, more rarely a pleuritis, or a pseudo-rheumatic affection of the periosteum and the fibrous portions of the muscles. In the same way a Pulsatilla blennorrhoea may change its location from one portion of the mucous surface to another. A leucorrhoea may change to a conjunctivitis or bronchitis. Such is the protean and erratic character of the Pulsatilla catarrh, that it may suddenly change to a neuralgia, a chorea, an arrest of nutrition, or a swelling of some of the glands, generally the testicles or ovaries.

Glandular System. — As intimated above, Pulsatilla may affect the glands indirectly, we believe never directly.

Vascular System. — (See Fever.) Pulsatilla does not appear to affect the heart and arteries directly.

Venous System. — It causes many symptoms . of venous stagnation, and has been used successfully in varicosus and other diseases of this system, but in what way it acts on these vessels I cannot say.

It causes eruptions on the back, legs, and ankles, of a dark, bluish-red color, attended through the day with more or less itching, but at night the itching is most intolerable. The eruption stands out prominently from the skin, and is from the size of a three-cent piece down to a miliary eruption. This eruption resembles measles.

It is homoeopathic to urticaria, papulae, or an eruption which begins as one of the former, but instead of disappearing, changes to pustules. In this respect it resembles its relatives, Clematis, Ranunculus, etc.

The observations above set forth may be found to be crude and incorrect, but in the absence of any pathological provings they are the best that I can give.

It is to be hoped the homoeopathic profession will make the American Pulsatilla an exhaustive study, both by pathogenetic (symptomatic) and pathological (toxical) experiments, in such a thorough manner as to arrive at its real sphere of action.

Skin. — Its action on the cutaneous surface is as specific as its action on mucous surfaces.

It has one head-symptom, almost identical with one found in the pathogenesis of Pulsatilla nigricans, viz., “ Headache arising from the nape of the neck and upwards.” The headaches of Puls. nutt. would seem to be both rheumatic and gastric, taking the form of hemicrania, “ clavus hystericus,” or from indigestion, in all of which it may prove useful. I have used this remedy in three cases of headache, one of which was cured by it. It was that of a lady in the country, whose case was described to me by the husband as “ sick-headache,” commencing in the middle of the day, with intense pain in one side of the head and one eye, accompanied by chilliness, lowness of spirits, and finally vomiting. The vomiting usually relieved the pain, after which she could go to sleep. Those paroxysms had occurred, usually, twice a week for

several years. She took five drops of the 2d dilution three times a day, for four weeks. After commencing the medicine, she had but two attacks of headache, the last paroxysm very light. It is now three months, and there has been no headache of any severity since.

The eye-symptoms are very decided. I have had better success with it than with its European relative in conjunctivitis, hordeolum , and swelling of the edges of the lid ( ophthalmia tarsi). There is a peculiar inflammation of the eye, occurring in persons of blonde complexions, light hair and blue eyes, brought on by taking cold. (I have not observed it in brunettes.) The eyelids are puffed, almost like oedema, and with the surrounding skin assume a livid, light-purple hue. This affection comes suddenly, and after lasting a day or two a profuse mucous secretion sets in from the conjunctiva, followed by improvement more or less rapid. In scrofulous subjects it often degenerates into a chronic state, accompanied by pustules and granulations. This Pulsatilla is specific for the disorder, and will hasten the favorable termination and prevent a chronic condition. Dr. Miller, of St. Paul, writes that he has cured several cases of opacity of the cornea of long standing, in which the loss of sight was nearly complete. He used a decoction of the plant, but does not mention the dose, but says “two fluid ounces were used in two weeks.” The provings would indicate its usefulness in catarrhal and neuralgic affections of the eyes.

I have known the most happy results follow its use in catarrhal otitis and otorrhoea.

In catarrhal angina, when the fauces and pharynx, as far as can be seen, are of a purplish or livid color, puffy, and the seat of stinging pains. Its throat-symptoms somewhat resemble those of Hamamelis and Gymnocladus, and the first stage of the Apis angina.

In cough it acts as well as the other species.

In gastro-enteric disorders, such as dyspepsia, indigestion, diarrhoea, colic, and vomiting, I find it acts very promptly.

The same may be said of its action on the urinary and genital organs.

I do not believe there is any difference in the quality of action

of the indigenous and foreign species of Pulsatilla, but I believe the quantity differs, i. e., the former is a much more powerful plant, and affects the organism more profoundly.

As intimated, when speaking of the action of Pulsatilla, I believe we would be more successful with this remedy if we thoroughly understood its method of action. From a careful study of it, I believe the keynote of its action is its power to cause catarrhal affections with peculiar concomitants, namely, neuralgic or rheumatic pains preceding catarrhal discharges, or following upon their suppression ; and inflammation of glandular structures resulting from suppressed catarrh.

Pulsatilla catarrhs result in leucorrhoea {vaginal and uterine), and even ovaritis, mucous metritis, and mucous cervicitis. The amenorrhoea of Pulsatilla generally results from a suppressed catarrh ; also the delaying menses, which are generally painful and scanty.

In the provings we find that it causes sharp pains in the uterus, from side to side, accompanied with chilliness, trembling weakness of the legs, urging to urinate, and diarrhoea. “ Menses more regular since proving the drug.”

Dr. Miller (allopath) writes that he has used it successfully in leucorrhoea and irregular menstruation. I have sent the tincture to many of my colleagues requesting them to use it in uterine diseases. The general testimony is that it acts more promptly than the European species.

In retention of the menses from a cold, or other incidental causes, and in recent cases, the Pulsatilla nuttalliana has proved curative in many instances.

The following case was published, with the original proving, and the experience of several physicians has since confirmed its clinical value :

Case I. — A young lady, on a visit to this city from Boston, who had previously been subjected to retardation of the menses, postponing three or four weeks beyond their usual time, applied to me for relief from the following symptoms :

Constant chilliness, coldness of the hands and feet, loss of appetite, sour eructations, nausea after meals, hemicrania, toothache, melancholy, and general malaise. The menses were retarded two weeks beyond their normal time. She said the precursory symptoms of menstruation occurred while on her way

to this city, at which time she caught a severe cold. No menstrual symptoms now.

This was a case in which any physician of our school would have prescribed the European Pulsatilla. I thought it a good opportunity to try the American plant. Thirty drops of the first dilution were mixed with half a glass of water, a spoonful to be taken every two hours. After the fourth dose the menses appeared without the usual pains, and with a permanent disappearance of all the constitutional symptoms. I think this may fairly be set down as a curative effect of Pulsatilla nuttalliana.

Since the above was published I have used it in several cases, only one of which I shall narrate, as it is similar to the rest. In some cases of amenorrhosa it has failed, and the menses had to be brought on with Senecio and Sabina.

Case II. — A young woman, usually healthy, plethoric, had the menses delay two weeks. Symptoms : Severe headache all the time ; a heaviness and fulness, aggravated by movement or stooping ; dimness of sight, increasing to blindness when stooping or rising suddenly; sensation of weight in the uterine region, with considerable aching pain extending to the back, very severe at times, especially in the evening ; hands and feet cold ; weakness in the lower extremities.

Cimicifuga was given a few days, but no improvement followed its use. Pulsatilla nuttalliana was given, five drops of the one-tenth every three hours. Improvement commenced the next day, and the menses came profusely, but without the uterine pain, about two days before the expiration of the eighth week. In this case a higher dilution would probably have acted better.

Dr. A. E. Small reports the two following cases of acute amenorrhoea in which this remedy seemed to act in a very prompt and powerful manner:

Case I. — A stout, middle-aged married woman had the menses delayed five days. This was so unusual that she applied for medicine to bring them on. No symptoms were complained of. Pulsatillana nuttalliana was prescribed, ten drops of the tincture in half a glass of water, a spoonful every hour. After the sixth dose the menses came on profusely but without pain.

Case II. — An unmarried woman, aged 18 ; menses had delayed three weeks beyond their usual normal period. Pulsatilla nuttalliana, given as in Case I, brought on the menses after the tenth dose.

A physician informed me that he gave the Pulsatilla nuttalliana to a stout, healthy woman, aged 35, who applied to him for a retardation of the menses, ten days past the natural time, no unpleasant symptoms resulting. Five drops of the mother tincture

every three hours brought on the menses, after the fifth dose, with “ headache, nausea, and diarrhoea.”

The action of Pulsatilla on the muscular and fibrous tissues is well known, but its use in rheumatism is not sufficiently appreciated or understood. It is of no use in idiopathic rheumatism, but is specific for that variety which is relieved by a catarrhal discharge or follows the suppression of a catarrh. The pains are generally flying, wandering, and rarely fixed, except on the dorsum of the feet.

Since I have prescribed the Pulsatilla according to this indication, the most excellent results have followed its use. I give the lowest dilutions or the matrix tincture, repeated until decided improvement sets in. I have known it to cause the reappearance of an intestinal or vaginal catarrh after they had been absent weeks and had caused the severest rheumatic neuralgias.

The following symptoms are especially noteworthy :

Frequent flying pains in the wrists and fingers, during the whole proving.

Hard drawing pains from the first to the second joint of the right middle finger.

Stiffness of the fingers.

Drawing pains in the left metacarpal bones.

Hands hot and dry — constant symptom.

Sharp, neuralgic pains passing from the hip-joint down to the middle of the thigh, along the course of the ischiatic nerve.

Severe, dull pains in the right knee-joint, for two hours in the morning, while in bed, during a rainstorm.

Sharp, drawing pains along the outside of the left knee, passing half-way down the leg.

At noon began to feel great weakness in the legs, could scarcely stand, and walking became difficult ; it was a “ trembling weakness,” with a sensation of great weariness and heaviness.

It cured the following case of rheumatismus fugax :

A strong, healthy-looking man applied for relief from wandering rheumatic pains, principally located in the dorsum of the right foot, and in the loins, thighs, chest, arms, and head. The pain in the head was a dull, heavy pressure in the vertex, nearly constant, with occasional sharp pains. Some febrile disturbances, but no local inflammatory action in the joints or muscular tissues. The urine was scanty and deposited lithates. There was acidity of the stomach ; bowels normal ; appetite good. After other remedies had been tried for a week, Pulsatilla nuttalliana was given, and removed all the symptoms in three days.

Another, but a little different attack occurred a few months after, and was removed again by the same remedy.

I have found it useful in melancholy , sleeplessness, and extreme nervousness in women and children.

My advice is to use it for all the ailments for which the European species is recommended.

I carry in my case the two species side by side, in the 2X dilution. I am favorably impressed with the action of the triturations made from the mother tincture of the fresh plant, not triturated long enough to dissipate the volatile principle (ten minutes is ample time).