Crataegus. Crataegus oxyacantha.

Synonyms—Hawthorn, Haw, English Hawthorn.

PREPARATIONS—

Specific Medicine Oxyacantha; dose, from five to twenty minims.

Fluid Extract Oxyacantha; dose, from ten to fifteen minims.

Normal Extract; dose, from four to eight minims. It is given in water and may be repeated every hour or every two or three hours. In extreme cases it may be given hypodermically.

Therapy—This agent has not yet received much attention from the profession. Dr. Jennings, of Chicago, in October, 1896, published in the New York Medical Journal a letter containing the following statement:

"To this date I have successfully treated with crataegus one hundred and eighteen patients who were suffering with various forms of heart disease, not including fatty degeneration and tachycardia, and of the two latter forms of the disease. I have fourteen still under treatment.

"Of one hundred and fifty-seven reports from other physicians using the drug in their practice, all but nine are commendatory and favorable, and of the nine, eight of them discontinued its use because the medicine made them sick at the stomach, and the ninth, a physician, said it gave him a fullness in the head. If these latter had reduced the dose to five or six drops it would have had full therapeutic effect, and would have obviated the nausea, and they, too, could then have reported favorably.

"From these results my deductions are that Crataegus Oxyacantha is superior to any other of the well known and tried remedies at present in use in the treatment of heart disease, because it seems to cure while the other remedies are only palliative at best.

"Crataegus may be regarded as specific, or the nearest approach to a specific, in the following cardiac diseases: Angina pectoris, valvular deficiency, with or without enlargement, endo-myo and pericarditis, tachycardia, rheumatism (co-called) of the heart, cardiac neuralgias, from whatever cause, palpitation, vertigo, apoplexy, dropsy, and functional derangements.

"The dose of ten to fifteen drops, heretofore announced, is too much, and a dose of from four to eight drops, four times a day, is to be substituted."

Jennings advises the use of tonics and auxiliary agents to meet the indications in extreme cases of heart disease, where a long train of symptoms has developed from the imperfect circulation and deficiency of oxygenation of the blood. He says in treating heart disease, he was strikingly impressed with the rapidity with which cardiac dropsy disappeared under the influence of crataegus. From this he was naturally led to believe that the same treatment would be equally efficacious in dropsies not of cardiac origin, and he now confirms, clinically, this obvious conclusion. He has also used crataegus with the greatest of success in albuminuria or Bright's disease, and in diabetes mellitus and insipidus.

Dr. Joseph Clements, of Kansas City, Mo., wrote to Dr. Jennings for information concerning the remedy, and began taking it. The report of his ease was published in the Kansas City Medical Record in April, 1898.

It was an extreme case of angina pectoris, with regurgitation, edema and a train of symptoms that pointed to immediate dissolution. After using Cactus and other well known heart remedies without result, he obtained some of Jennings' fluid extract, and was cured in a few weeks, with permanent relief from the pain.

Dr. Clements believes that his experiments have shown that the drug also has a wonderfully solvent power on crustaceous and calcareous deposits in the lumen of the arteries, resembling the effect of iodide of potassium on the nodes of syphilis.

He says further, "a drug whose physiological action and therapeutic power are solvent and absorptive to the diseased accumulations, and tonic and stimulative to its nutritive nerve supply, must approach the nature of a specific as near as anything can approach it, in the disease under discussion."

Some observers claim that the use of this remedy in aged persons, with arteriosclerosis, angina pectoris, etc., will prolong their lives beyond the time when dissolution would have been certain had those conditions remained.

What would be the effect of the medicine in fatty degeneration, atheroma, etc., I am not prepared to say. I think further observation will be necessary before it would be safe to go far with it. In small doses, however, its tonic effect upon the nerve supply, I think, could not be otherwise than helpful.

In beginning heart mischief after attacks of inflammatory rheumatism we will find a promising field of usefulness for this new remedy.

Those who have since used the remedy believe it to be a true heart tonic and restorative and capable of exercising an immediate soothing and strengthening influence upon that organ, thereby improving the circulation, and augmenting oxygenation of the blood. Future experience will determine its merit. I will now say, as I did in 1907, this remedy, although of great service in selected cases, when used in combination with cactus or other heart agents, when used alone has hardly met the anticipations of those who were carrying out the suggestions of the original introducers of this remedy. It will meet a few indications satisfactorily. I have prescribed it in the heart weakness with valvular murmurs, great difficulty in breathing, persistent sighing respiration, which accompanies neurasthenia or nervous weakness, brought on in young people, from violent overstrain, or prolonged extreme nervous tension. The results of the sudden breakdown, being similar in every way to other cases of neurasthenia.

One case was completely cured in about six weeks, by the use of this remedy, and the arsenate of strychnia. The valvular murmurs showed a progressive decrease until they had disappeared entirely, as did also the extreme sighing and difficult respiration. Other cases complaining of heart irregularity with mild valvular trouble, have been materially benefited by crataegus.

That it has an important place in our therapeutics, we have no doubt, but its exact place is not yet determined.

Dr. Jernigan experimented very extensively with crataegus and believes it is superior to many heart remedies when correctly prescribed. He believed it to have a broader field of action; no accumulative effect; no toxic influence; no contraindications, and acts in harmony with the other remedies.

It has a general curative effect upon the functional action of the central nervous system; upon every part of the circulatory apparatus; upon the urinary organs, and the processes of metabolism. It dispels gloomy forebodings, increases the strength, regulates the action of the heart, causes a general sense of well being. In its mental influence he thinks he sees a resemblance to the action of pulsatilla, and very often prescribed the two remedies in conjunction.

The doctor is sure he has seen excellent results from crataegus in the treatment of diabetes insipidus, especially in children, a difficult condition to control. He has used it also in exophthalmic goiter with good results. He gave ten drops of the specific medicine every two hours for a while, controlling a form of epilepsy that showed itself with the other symptoms. He believes the remedy given for diabetes influences innervation, improving the circulation, especially in the capillaries when there were cold extremities. All of his cases confirmed his faith in the remedy as an important one for this condition.

Dr. Dwire, of Ohio, in his report confirms all of Dr. Jernigan's statement in its action directly upon the heart.

Dr. Sharp, of Ohio, says that he finds crataegus indicated in the usual diseases of the heart, and gives it in conjunction with the very best possible treatment to put the system into normal condition with proper diet and attention to the action of the skin, kidneys, and bowels. He reports three cases of serious heart disease in patients above 78 where the results were highly satisfactory.

Dr. Stouffer, of Pennsylvania, suffered from a number of mild attacks of paralysis of the left side. The heart was directly influenced; oppression heavy; constriction of the throat; all symptoms increasing by exertion. He combined crataegus and scutellaria, two parts of the former to one part of the latter, adding oil of peppermint, a few drops for the flavor. Of this he took a drop or two on his tongue very often, or as needed, obtaining relief, not secured by any other measure.

A greatly enlarged heart in a young man of sixteen with the symptoms usually present in older patients with precordial bulging was permanently benefited until a permanent cure seemed to be possible, by five drop doses of crataegus every three hours persisted in, over a period of several months.

Dr. Osborne cured himself of a peculiar asthmatic difficulty of the spasmodic type. He had enlargement of the right side of the heart, the oppressed breathing at times being very severe. In a paroxysm, he took eight drops of crataegus every fifteen minutes with almost immediate relief. There was no complete cure but much benefit.

Young women, who from any cause suffer from mitral insufficiency, especially if rheumatism is present or the conditions that lead to it, may be cured by proper care and the use of five drop doses of crataegus three or four times a day.

The American Materia Medica, Therapeutics and Pharmacognosy, 1919, was written by Finley Ellingwood, M.D.
It was scanned by Michael Moore for the Southwest School of Botanical Medicine.