Veratrum viride

PNEUMONIA.

Verat. viride I wrote in “Leaders” that at one time it had a great reputation in the first or congestive stage of inflammatory diseases, and especially in those organs coming under control of the pneumogastric nerve, viz., pharynx, œsophagus, stomach and heart. For a time the journals fairly bristled with reported cures of pneumonia, and its curative power was attributed to the influence of the remedy to control the action of heart and pulse. It was claimed that if we could control the quickened circulation so as to decrease the amount of blood forced’ into the congested lung, that you thereby gave the lung a chance to free itself of the existing engorgement.

It looked plausible, and certainly in many cases remarkable cures were effected, and that in a short time. I was a young physician and thought I had found a prize in this remedy. But one day I left a patient, apparently relieved by it of an acute attack of pneumonia, to go to a town five miles distant, and when I returned found my patient dead. Then I watched others so treated, and found every little while a patient with pneumonia dropping out suddenly when they were reported better. Now we don’t hear so much of Veratrum viride as the greatest remedy for the first stage of this disease. What was the matter? 1st. It was (like other fads) used too indiscriminately. 2d. It is not desirable (it is wrong) to control or depress the pulse regardless of all the other conditions. 3d. The patients who had weak hearts were killed by this powerful heart depressant. A quickened circulation is salutary in all inflammatory diseases, and is evidence that the natural power to resist disease, is there and at work. The pulse will come to its normality when the cause of its disturbance is removed and should never be forced to do so until then. Here is a common fault of the old school, notwithstanding their cry of “Tolle causam.” So I find fault with Guernsey’s key-note, “Great activity of the arterial system; very quick pulse.” Next to Digitalis, Veratrum viride slows the pulse, as is abundantly shown in the provings. If quick pulse is ever the result of this remedy, it is a secondary or re-actionary effect, like the sleeplessness of Opium or the constipation of cathartics. So it seems to me that as an antiphlogistic (forgive me) it must go into the shade with the once vaunted Digitalis.

Gatchell writes (pocket-book): “This is the most important remedy in the stage of engorgement, to which its use must be limited. In my own experience and in that of others, it has apparently cut short oncoming attacks of pneumonia. It must be given early, immediately following the chill. It is of no avail after hepatization has begun. Again, if it produces nausea reduce the dose. Watch the action to avoid cardiac depression.” I should object to the wholesale assertion that this is the most important remedy, for the most important remedy is the homœopathically indicated one, and it is not Verat. viride always by any means. I fully concur with him in the necessity of watching its action and for the same reason. I do know of one good characteristic indication for its use, not only in congestion of the lungs, but in other congestions also, viz., the well defined red streak running right through the middle of the tongue.

It has been repeatedly verified. So while it is true that it may be able to cut short oncoming cases of this disease, I should be sure one of the other more safe remedies was not indicated before I would use it, especially in weak heart cases.