Veratrinum

An alkaloid (Caj-^N^Og) found in the seeds of Sabadilla, and in the roots of Veratrum album and Lobelinum.

Prepared almost exclusively from Sabadilla.

Preparation, Triturations.

Authorities. (1 to 6 from Dr. Both, Journ. de la Sac. Gall., Mat. Med. Pura, vol. i, p. 536.) 1, Magendie’s, Formulate de, 1827, p. 65; 2, Bardsley, Journ. deChim. Med., vol. viii, p. 289; 3, Kopp, Denkwiirdegkeiten, vol. iv, p. 305; 4, Reich, Preuss. Med. Zeit., 1839, No. 23, p. 117 ; 5, Gerard, Szerlesky Zeit. fur Ther., vol. i, cap. 3, p. 145, 1841; 6, Ebel, Hufel. Journ., vol. Ixxxvii, cap. 2, p. 73; 7, A. Trombull, M.D., On Med. Properties of the Nat. Order Ranunculaceje, Philada., 1838, effects of internal administration and of ointment; 8, Dr. F. A. Force, Phys. and Ther. Researches concerning Veratrine (Brit, and For. Med.-Chir. Rev., 1839 (2), p. 363), effects upon the human body in healthy and morbid conditions; (9 to 12, from Husemann, Pflanzenstoffe, p. 509); 9, Esch de Veratrine; 10, Von Praag, Virchow’s Arch., 7, effects of 3 milligrams, four times a day, on a patient suffering from faceache; 11, Ebers, Casper’s Woch., 1835, effects of internal use of 3 to 6 milligrams; 12, same, effects of rubbing in the skin over the stomach; 13, Szerlesky, compiled by Dr. Kurt, Gist. Zeit. fur Horn., 4, 454, internal administration of ygth grain and larger doses, twice a day; 14, same, effects when used externally, especially in rheumatic or renal affections ; 15, Pharm, Journ., vol. x, 1850-1, p. 521, a man took 29 grains in a glass of hot ale; 16, Samuel R. Percy, M.D., an Inquiry into the Physical and Medical Properties of Verat. vir., Philada., 1864, p. 76, a physician took 30 grains; 17, C. P. Blake, St. George’s Hosp. Rep., vol. V, 1870, p. 69, a woman swallowed some liniment containing about 3 grains.

Mind p. 70

Delirium, with illusions of the senses

Anxiety

Great anxiety

Loss of consciousness

Head p. 70

Vertigo ”; (after 12 milligrams)

Great giddiness

Dull headache (after 12 milligrams)

A peculiar sensation of oppression and anxiety in the head, a sense of suffocation

Eyes p. 70

Redness of the palpebral and corneal conjunctiva,®

[lO-] Lachrymation

Pupil extremely contracted

Nose p. 70

Frequent sneezing

After vomiting had been produced, violent sneezing came on, and continued for about half an hour

Face p. 70

Twitching of the muscles of the face (after 6 milligrams)

• Violent shocks, tearing pains extending from the face (the place of application) to the vertex

For some considerable time afterwards, when she was eating or laughing heartily, or talking animatedly, there would frequently be a spasmodic closure of the lower jaw, which would shut suddenly with a loud snap

Loath p. 70

Tongue much swollen

A p^ulnar biting and formication of the tongue

Dryness of the mouth

Mouth and throat very sore, as if she had swallowed boiling water

Intense irritation (caused by the acridity of this agent) of the mouth and pharynx

Salivation (after 24 milligrams)

Flow of saliva in the mouth

Very profuse salivation

Frequent salivation, nausea, and vomiting

Profuse salivation, lasting several weeks, but without any affection of the tongue or gums

Throat p. 70

Constriction of the throat (after 24 milligrams)

Sense of constriction in the fauces rendering swallowing difficult

Prickling sensation in the pharynx and stomach, sometimes intolerable

Stomach p. 70

Appetite and Thirst. Loss of appetite

Thirst,**.-^Violent, unquenchable thirst

Eructations. Frequent bitter eructations (after 12 milligrams)

JSfaasea and Vomiting. Nausea; (after 12 milligrams)

Feelings of sickness

A degree of nausea, but this may be obviated by taking care that too large a dose be not given at one time (after 4 or 6 grains, in twenty-four hours)

Violent nausea and vomiting (after 6 milligrams)

Transient nausea, with constipation

Nausea and vomiting *®.

Vomiting ®.

Copious vomiting

Stomach. Slight transient burning in the stomach

Coldness of the stomach (after 6 milligrams)

A peculiar feeling in the stomach, increasing after large doses to a burning

Cramp of the stomach

Abdomen p. 70

Electric streams along the nerves of the abdomen and breast (from an inunction to the back)

Great pain extending over all the nerves of the abdomen

Colic

A peculiar sensation which she described as if the whole of the intestines were tied together by a strong cord continually tightened

Stool p. 70

Diarrhoea

Slimy diarrhoea (after 24 milligrams)

Profuse watery stools

Relaxation of the bowels with tenesmus

Very copious stools

Soft stools (after 12 milligrams)

Stools of bloody mucus

Evacuation of mucous substances

Urinary Organs p. 71

Spasmodic contraction of the bladder, with evacuation of watery urine

Urging to urinate

Continual calls for micturition independently of the quantity passed during the action of the bowels, which had freely moved twice or thrice

Ineffectual efforts to urinate (primary effect)

Increased secretion of urine (secondary effect)

Scanty, red, thick urine

Respiratory Organs p. 71

Breathing hurried

Heart and Pulse p. 71

Burning pain in the precordial region

Excessive feebleness in the action of the heart

Pulse quick and small

Decided diminution of the beating of the heart

Sinking of the pulse from 90 to 72,'®.

Pulse fell from 90 to 64 (after 6 milligrams)

Loss of pulse at wrist

Back p. 71

Dull pain in the back

Dull pain, afterward burning, in the lower part of the spinal column, followed by pain in the bowels and prepuce, watery and mucous evacuation, accompanied with jerking in the lower extremity

Draining pain along the spine

Sensation of boiling water running over the back

Upper Extremities p. 71

Paralysis of the limbs

Feeling of numbness and formication in the extremities

Painful jerking in the toes

Generalities p. 71

Trembling and uncertain movements, when he wishes to lay hold of anything, he misses his grasp

Subsultus tendinum (after 6 milligrams)

Twitchings

Slight twitchings in various muscles

Felt dreadfully tired, weak, and faint, as if she had undergone some tremendous exertion, though she had enjoyed an excellent night’s rest

Great weakness (after 24 milligrams)

Prostration

Faintness (after 6 milligrams)

Violent collapse, with vertigo, obscuration of vision, paleness of the face, cool skin, weak, irregular, rapid pulse, followed by violent vomiting, trembling of the whole body, sweat, depression (after 3 milligrams of Acetate)

Great agitation, with violent vomiting

After a person has taken, for two or three times, from ^th to :^th of a grain of Veratria, frequently, indeed, in from half an hour to an hour after the first dose, there arises a feeling of tingling, sparkling, prickling, in parts remote from the stomach, most commonly in the joints of the fingers and toes, sometimes in the elbows, bends of the knees, and shoulders, occasionally on the forehead or over the eyebrows, more rarely and at longer intervals in the thighs, abdomen, or back. Simultaneous with this, or soon after, some patients experience a sense of warmth, others of cold, referred to different regions of the extremities and trunk, mostly in the hands and soles of the feet, the knees and mouth. While one has the feeling as if a stream of warm air or drops of hot water were issuing from these parts, another perceives, as it were, a frozen atmosphere around the feet, and particularly the knees, or as if cold water was poured upon them. Some compare the sensation in the mouth to that produced by sucking peppermint. In general the warmth occurs where there is integrity of the vital powers, but abdominal torpor, while old hypochondriacs and hysterical women, with predominant asthenia, experience the cold

Sensation of warmth in the stomach, which gradually extends itself over the abdomen and lower part of the chest; after the dose has been repeated once or twice, the same feeling is experienced in the lower extremities, and particularly in the feet; the upper extremities and head become also affected in the same manner, and if the medicines be pushed further, a sensation of tingling, exactly similar to that caused by friction with Veratria ointment, manifests itself in various parts of the body, and sometimes over the whole surface of the skin ; this is generally accompanied by considerable perspiration, and some feeling of oppression, and all these effects are augmented by heat, or by the use of warm diluents; to this succeeds a sensation of coldness; and should their administration be still continued the stomach becomes affected, and a degree of nausea takes place, followed by vomiting. In a few instances only have they acted as diuretics, and in still fewer as purgatives (after g grains)

Sensation of electric streams in the nerves,’k

Shooting pain like electric shocks, in various muscles and joints

Beside the above sensations, there is occasionally superinduced this peculiar phenomenon, namely, that a pain, which may have been of long standing in some part of the body, either suddenly disappears altogether, or else is replaced by another, equally sudden in its invasion, in some distant part. Examples are not wanting of a limb or of the muscles of the face, especially if previously the subject of painful or spasmodic paroxysms, becoming seized with starting and tremor soon after taking the medicine. Thus, in from half an hour to an hour after the dose had been swallowed, parts began to start, which were in a half paralyzed state from apoplexy, or which used to present violent spasms or trembling during severe paroxysms of tic douloureux. In some cases the development of heat was very marked. In the case of a torpid lymphatic subject, in whom, from “abdominal epilepsy the left arm had gone into a half-palsied state, attended with frequent twitchings, a fleeting but sensible warmth succeeded the application of Veratrine

Antidote: coffee, mixed with a little lemonjuice

Skin p. 72

When rubbed into a very delicate skin it sometimes causes an erysipelatous inflammation, with inflammatory redness and very violent pain, even nettlerash eruption

Sometimes an evanescent blush pervades the surface, and in rare instances a quantity of eruption has appeared upon the part, but these bear only a small proportion to the cases in which no effects were produced (from application of ointment)

After the ointment has been applied a sufficient length of time to put the constitution completely under its influence, the feeling of heat and tingling extends itself from the place where the friction may have been made, over the whole surface of the body, and produces sensations similar to those arising from the internal use. The sensibility of the parts over which the application has been made, is increased so as to render them peculiarly susceptible of the presence of certain stimuli, particularly electricity or galvanism ; these agents have in some instances been applied along with the Veratria ointment, but have given rise to sensations so acute as to render their further employment almost insupportable, and that without the slightest perceptible alteration of the surface (after application of ointment)

At least two months after the itching had subsided, there continued an exceedingly troublesome tingling all over the skin, as if she had been stung by nettles, though without any rash, or indeed any sort of appearance of irritation

A continual tingling over the skin, and now and then sudden fits of the most unbearable itching in different parts of the body, compelling her to scratch and rub vigorously in the most uncontrollable manner

Fever p. 72

Coldness, warmth, sticking, and prickling

Cold extremities

The extremities are so cold that he is obliged to use a footstove

Sweat