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Pulsatilla.

The recent herb of Anemone Pulsatilla, Linné, and of Anemone pratensis, Linné, collected soon after flowering (Nat. Ord. Ranunculaceae). Southern Europe and Asia.
Common Names: Pasque-Flower, Passe-Flower, Meadow Anemone, Wind Flower.

Principal Constituents.—A yellow, acrid oil, yielding anemone camphor, a vesicating principle easily decomposing into anemonin (C10H8O4) and isoanemonic acid.
Preparation.—Specific Medicine Pulsatilla. Dose, 1/10 to 10 drops. ( The usual form of administration: Rx Specific Medicine Pulsatilla, 5-30 drops; Water, enough to make 4 fluidounces. Mix. Sig.: One teaspoonful every 2 or 3 hours.)

Specific Indications.—Nervousness with despondency, sadness and disposition to weep, without being able to tell why, or to weep while asleep; unnatural fear; fear of impending danger or death; morbid mental excitation associated with physical debility; marked depression of spirits; insomnia, with nervous exhaustion; pain, with debility; headache, with nervousness, not dependent on determination of blood to the head; neuralgia in anemic nervous subjects; mental depression and gloom over reproductive wrongs and disturbances, as spermatorrhea, and tardy and insufficient menstruation (with sense of fullness and weakness in back and hips); nervous collapse, due to overwork, sexual indulgence, masturbation, or to the excessive use of tobacco; amenorrhea with chilliness and mental depression; dysmenorrhea, with gloomy mentality and chilliness; pain from exposure to winds; epiphora; styes; deep-seated heavy pain in the globe of the eye; jumping toothache from abscess near the dental pulp; stomach disorders from indulgence in pastries and fats; pasty, creamy, or white coating upon the tongue, with greasy taste; thick, bland, and inoffensive mucous discharges; alternating constipation and diarrhea, with venous congestion.

Action.—Topically applied, the fresh plant of pulsatilla is irritant, and, if kept long in contact with the skin, may vesicate. When chewed, it produces a benumbing sensation and tingling formication, somewhat like that produced by aconite or prickly ash. Taken internally in overdoses, it is a gastric irritant, producing a sense of rawness, burning pain in stomach, with endeavors to vomit, all accompanied by marked prostration. A sense of constriction and tightness of the chest, with chilliness, marked weakness, and some congestion, has been produced by large doses. Full doses depress the action of the heart, lower arterial tension, and reduce temperature. Sensory and motor paralyses have followed very large doses of pulsatilla, while toxic doses may produce mydriasis, stupor, coma, and convulsions. In medicinal doses, pulsatilla increases the power and regulates the action of the heart, and gives a better character to the pulse rate, particularly slowing the irritable, rapid and feeble pulse due to nervous depression. It improves the sympathetic system and cerebral functions, and especially strengthens sympathetic innervation, this action being very marked in troubles of the reproductive organs of the male and female.

Therapy.—External. The value of pulsatilla has been emphasized in "jerking" or "jumping" toothache, usually due to the formation of a pus cavity near the nerve. Full strength specific medicine pulsatilla, or diluted one-half with water, is applied besides giving the drug internally. This treatment is also commended as "especially useful in inflammations caused by dead teeth, and the inflammatory, painful, and unpleasant conditions of the pulp cavity in those in which the nerve has been destroyed."

Internal. Though not of Eclectic origin, pulsatilla is one of the most important medicines in Eclectic therapy. For certain nervous phases, both in acute and chronic diseases, no remedy can exactly duplicate its action. It is most largely employed in nervous conditions of the debilitated, particularly women and children, in mental disorders, and in stomach derangements and disorders of the reproductive tract with debility and faulty nutrition of the nerve-centers. All through the indications for pulsatilla run depression and irritability with melancholy and sadness, and a disposition to look upon the dark side of life. With this gloomy mentality there is more or less of restlessness. The patient is easily inclined to weep, is unsettled and the mind wanders. Thought is concentrated with difficulty, the pulse is soft, open, and weak, and altogether the patient is miserable and despondent. Scudder, who introduced it into Eclectic practice, declared its most important use is to allay irritation of the nervous system in persons of feeble health, thus giving sleep and rest, preventing unnecessary expenditure of nerve force, and by this means facilitating the action of tonics and restoratives. He found it to be most certain in its action in feeble women and men who have become nervous from sedentary habits or mental overexertion, as well as in the nervousness and restlessness of masturbators, or persons addicted to the excessive use of tobacco. He also declared it the remedy for nervous women when there is debility and faulty nutrition of the nerve centers.

Pulsatilla, though a remedy of wide applicability, is particularly adapted to conditions in which the depressed mind is a prominent factor. A gloomy mentality, a state of nerve depression and unrest, a disposition to brood over real or imagined trouble, a tendency to look on the dark side of life, sadness, mild restlessness, and a state of mental unrest generally denominated in broad terms "nervousness", are factors in the condition of the patient requiring pulsatilla. As stated before, the pulsatilla patient weeps readily, and the mind is inclined to wander-to be unsettled. The pulse requiring pulsatilla is weak, soft, and open, and the tissues have a tendency to dryness (except when the mucous tissues are discharging thick, bland material), and about the orbits the parts appear contracted, sunken, and dark in color. The whole countenance and movements of the body depict sadness, moroseness, despondency, and lack of tone. Hysteria of the mild and weeping form may be a symptom. The complex is one of nervous depression, the nutrition of the nerve centers is at fault. With such symptoms, pulsatilla may be confidently prescribed in the conditions and disorders enumerated in this article.

Pulsatilla may be given to induce sleep when there is great exhaustion and opiates are inadmissible. If the insomnia depends upon determination of blood to the brain, pulsatilla will not relieve, but when due to nervous exhaustion it is a prompt remedy to give rest, after which sleep obtains. Where sleep is disturbed by unpleasant dreams, and the patient awakens sad and languid, pulsatilla should be given.

Pulsatilla has a large field of usefulness in troubles incident to the reproductive organs of both sexes. As an emmenagogue, it serves a useful purpose in amenorrhea in nervous and anemic subjects, with chilliness a prominent symptom. When menstruation is suppressed, tardy or scanty from taking cold, or from emotional causes, pulsatilla is the remedy. In dysmenorrhea, not due to mechanical causes, and with the above-named nervous symptoms, few remedies are more effective. leucorrhea, with a free, thick, milky or yellow bland discharge and pain in the loins, and particularly in scrofulous individuals, calls for pulsatilla. It is useful in mild forms of hysteria, where the patient is weak and weeps, has fears of impending danger, and passes large quantities of clear, limpid urine, and menstruation is suppressed. The long-continued use of pulsatilla as an intercurrent remedy is accredited with curative effects in uterine colic, but it is of no value during an attack. Pulsatilla frequently relieves in ovaritis and ovaralgia with tensive, tearing pain. Sluggish, ineffectual, and weak labor-pains are sometimes remedied by this drug, though it is seldom used for this purpose since more active agents have come into use. It frequently alleviates pain when dependent on or associated with debility, and sometimes when due to acute inflammation. In epididymitis and orchitis, whether due to gonorrheal infection or to metastasis from mumps, it is quite universally employed by practitioners of all schools of medicine. Here the dose should be large. The dark-red, congested, enlarged, and sensitive testicle indicates it. It relieves the pains of orchialgia, and subdues mammary swelling from the metastasis of mumps. Pulsatilla increases sexual power, but lessens morbid sexual excitement. It is especially valuable in relieving urethral irritation and consequent spermatorrhea and prostatorrhea. In these troubles it overcomes the nervous apprehension so frequently a troublesome feature. It also alleviates the nervous irritability accompanying or produced by varicocele. In gonorrhea, particularly of the chronic type, pulsatilla is of value when the urethral membrane is swollen. Many unpleasant conditions of the urinary apparatus are relieved by pulsatilla, as frequent but ineffectual attempts at urination, the bladder giving a sensation as if bloated; dribbling of urine from movement, the dysuria of pregnancy, and in involuntary micturition from colds or from nervous debility.

Pulsatilla is a useful remedy in headache of various types. It relieves frontal headache from nasal catarrh; nervous headache, particularly when due to gastric disturbances, with greasy taste; menstrual headache, with chilliness and suppressed menses; bilious and gastric headaches, of a dull and heavy character, with greasy taste and nausea; and headache due to uterine irregularities or to a rheumatic diathesis. These headaches are all of anemic character—the opposite of those relieved by gelsemium. Constipation in the hysterical female sometimes yields to nux vomica and pulsatilla, and the latter has a pleasing action in some forms of indigestion and dyspepsia. These are the cases in which there is a thick, creamy paste upon the tongue and a greasy taste. Such troubles are frequently brought about by indulgence in pastries and fatty food. Pain is not marked, but there is pyrosis and greasy eructations, gastric distention, uneasy gnawing sensations in the stomach, and chilliness may be a pronounced symptom. The patient is nervous, sad, and may have a soft, yellow diarrhea. For such cases pulsatilla is an excellent remedy. It is also said to relieve alternating constipation and diarrhea with venous congestion.

Though ordinarily not a remedy for acute inflammations (contraindicated in gastro-intestinal inflammation), there are some conditions where small doses of pulsatilla are beneficial when the usual symptoms calling for the drug are present. These are acute inflammation of the nose, fauces, larynx, or bronchi. It is especially effective in the secondary stage of acute nasal catarrh, when the naso-pharynx is affected and there is a sense of rawness and moisture, and an abundant discharge of thick, yellow, bland, inoffensive mucus or muco-pus. Pulsatilla often serves a good purpose in asthma superinduced by pregnancy, or by suppressed menses, and it favorably influences whooping-cough in properly selected cases. So-called "stomach cough" is frequently cured by pulsatilla. For the secondary stage of common colds, when the Eustachian tubes feel stuffed and occluded, with a moderate degree of deafness, pulsatilla alternated with gelsemium provides a most beneficial treatment.

Pulsatilla is a very important remedy to control the catarrhal symptoms of the exanthemata; it also allays the irritability frequently accompanying these disorders. In measles, it has done good service in checking the coryza and profuse lachrimation, as well as the dry, tight, painful cough, and when retrocession of the eruption has taken place, it has reversed this unpleasant condition. It relieves the nervous irritability in varicella.

Pulsatilla is a most efficient drug in real and imaginary cardiac affections. It has proved useful in cardiac hypertrophy and in dilatation of the venous heart. It is especially effective in functional heart disorders with giddiness, imperfect voluntary motion, impaired vision, and with a symptom described as a sense of pressure over the larynx and trachea, with imperfect respiratory movement, and sense of impending danger; these symptoms are not unfrequently associated with functional heart disease, dyspepsia, uterine disease, or over-excitation of the sexual system, and are generally very unpleasant and annoying. It often relieves that form of venous congestion which stops short of inflammation, as in threatened ovaritis, orchitis, varicocele, and crural phlebitis. Varicocele and other varicoses are sometimes improved by its administration with other indicated remedies. Its chief advantage, outside of some control over the venous structure, is the relief it gives from the nervous complications. It has been used to good advantage for the relief of the nervousness attending hemorrhoids, and has some control over the venous congestion causing them. Pulsatilla gives prompt relief in earache, brought on by cold, wet, and exposure to winds. For this purpose it is the best drug we have used. There is an absence of fever, the pulse is open and soft, the child sobs, the face is pale, the tissues full and waxen, the pain is intense and frequently paroxysmal and tearing in character—evidently a neuralgic condition, for physical signs of local disturbance are seldom observed. In purulent otitis media, with thick, yellow, bland discharge, and impaired hearing and tinnitus aurium, pulsatilla is the indicated remedy.

One of the earliest uses of pulsatilla was for the relief of "amaurosis, cataract, and opacity of the cornea", conditions in which the reputed value of pulsatilla is very much overrated. There is a condition, sometimes known as "nervous blindness", which has been benefited by pulsatilla, and this is probably that formerly referred to under the elastic term amaurosis. Pulsatilla has an excellent record as a remedy for hordeolum or "stye". It also relieves promptly when the conjunctiva is hyperaemic and vision weakened, especially after reading, or from sexual abuse or sexual excesses, and in profuse lachrimation from exposure to winds or when in the wind. It should be used locally (10 drops to water, 2 fluidounces) and also given internally in small doses. In chronic conjunctivitis, with bland, yellow discharges, in scrofulous individuals, or due to the exanthemata, and in ophthalmia with like discharge, pulsatilla has been used with success. It relieves deep-seated, heavy pain in the globe of the eye, and has been recommended in inflammation of the lachrymal sac.

Pulsatilla has been used with varying degrees of success in rheumatism, when the pains were shifting and relieved by cold and aggravated by warmth. Depression of spirits is here a prominent feature. It has also aided in restoring the flow of milk in agalactia in nervous and fear-depressed women, whose breasts were painful and swollen. The dose of specific medicine pulsatilla is from a fraction of a drop to ten drops, administered in water; of anemonin, 1/20 to 1/4 grain.


The Eclectic Materia Medica, Pharmacology and Therapeutics, 1922, was written by Harvey Wickes Felter, M.D.



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