The root of Asclepias tuberosa, Linné (Nat. Ord. Asclepiadaceae). United States and Canada. Dose, 5 to 60 grains.
Common Names: Pleurisy Root, Butterfly Weed, Orange Swallow-wort.
Principal Constituents.—Resins and a glucoside.
Preparation.—Specific Medicine Asclepias. Dose, 1 to 60 drops. (Usual form of administration: Specific Medicine Asclepias, 20 drops to 2 fluidrachms; Water, 4 ounce. Mix. Sig. One teaspoonful every 1 or 2 hours.)
Specific Indications.—"Pulse strong, vibratile; skin moist; pain acute, and seemingly dependent on motion" (Scudder). Skin hot and dry, or inclined to moisture; urine scanty; face flushed; vascular excitement marked in the area supplied by the bronchial arteries; inflammation of serous tissues; gastro-intestinal catarrhs due to recent colds.
Action.—The physiological action of asclepias is not extensive, but important. Asclepias slows the action of the heart and lowers arterial tension. It especially relieves local hyperemia by vaso-motor control. Through some unexplained, though probably circulatory regulating action upon the sweat-glands it produces a true diaphoresis, including the elimination of both solids and liquids, the latter sparingly and almost insensibly. Its regulation of the true secretion of the skin more nearly resembles that of normal or insensible perspiration than that caused by any other diaphoretic, corallorhiza possibly excepted.
Therapy.—Asclepias is one of the most important medicines for broncho-pulmonic inflammations and catarrhs, and an agent for re-establishing suppressed secretion of the skin. It is the most perfect diaphoretic we possess, so completely does it counterfeit the normal process of insensible perspiration. When the secretion of sweat is in abeyance it restores it; when colliquative it restrains it through its effect of promoting normal functioning of the sudoriparous glands. It may be indicated even though the patient be freely perspiring, for sometimes when the liquid excretion is abundant there is a retention of the solid detritus, the removal of which is one of the effects of asclepias. By softening and moistening the skin, temperature is safely reduced. Asclepias never causes an outpouring of drops of sweat. If such occurs, it is due to bundling with bed-clothing, or the too copious administration of either hot or cold water with. it. Given in alcoholic preparations, in the usual small doses, it merely favors the reestablishment of natural secretion. While asclepias is serviceable when the temperature is high, it does its best work when heat is but moderately exalted, and when the skin is slightly moist, or inclined to moisture, and the pulse is vibratile and not too rapid. In fact, in febrile and inflammatory disorders asclepias is not a leading remedy, but is largely a necessary accessory. If the pulse be rapid and small, aconite should be given with it; if rapidly bounding, large and strong, veratrum. While useful in disorders of adults, especially old persons, asclepias will be most often indicated in diseases of infants and children. While it acts best when strictly indicated, it is almost never contraindicated in acute respiratory affections.
In acute chest diseases asclepias is useful to control cough, pain, temperature, to favor expectoration, and restore checked perspiration. When cough is dry and there is scant bronchial secretion, asclepias stimulates the latter and thus relieves the irritation upon which the cough depends. In chest disorders requiring asclepias our experience verifies the classic indications for it.
The asclepias condition in broncho-pulmonic disorders shows either a hot and dry skin, or there is pungent heat of the skin with inclination to moisture, the pulse is usually full and active and even may be bounding, much as when veratrum is indicated. The face is flushed, there is, in children particularly, marked restlessness, and more or less febrile reaction. In chest disorders there is pain upon motion—pleural pain—and the cough is short, hacking, barking, rasping, and nervous-and restrained as much as possible on account of the pain and soreness it occasions. Bronchial secretion is arrested, though that of the skin may be in evidence. The early Eclectics were neither dreaming nor romancing when they voiced their verdict concerning the great value of pleurisy root in pleuritic and other chest affections.
With the conditions named asclepias is of the very greatest value in acute coryza, la grippe, acute bronchitis, pleuro-pneumonia, and pneumonia, both catarrhal and croupous. Its use should be begun early, usually in association with other agents sure to be indicated, and continued through the active stage; and if a dry cough persists it should still be continued and used freely. There is no kindlier cough medicine than asclepias, and when fever is present it is an ideal aid to the special sedatives. Asclepias should form an important part of the medication in acute pleurisy and pleurodynia, conditions in which it is most efficient and in which it first earned a therapeutic reputation. It may need to be fortified by the intercurrent use of aconite or bryonia, or both, and in any case it will enhance the value of these agents.
In pneumonia and in bronchitis asclepias is best adapted to the acute stage, where the lesions seem to be extensive, taking in a large area of the parenchyma of the lung or the bronchial structures and the mucosa. Webster declares it best adapted to control vascular disturbances in the area supplied by the bronchial arteries, and suggests that by reserving it for this use we shall lessen its liability to confusion with other appropriate remedies. In the convalescent stage of pneumonia and other respiratory lesions, when expectoration is scanty and dyspnea threatens, small doses of asclepias are helpful. It renders a similar service in dry, non-spasmodic asthma. The dose for these purposes should be about 5 drops of the specific medicine.
Asclepias is an admirable or adjuvant remedy for the acute catarrhal states of the broncho-pulmonary or gastro-intestinal tracts when produced by recent colds. Full doses will sometimes "break" ordinary colds. Asclepias, euphrasia, and matricaria are the best three agents for "snuffles" or acute nasal catarrh of infants. In the irritable mucosa and distressing cough of phthisis it is a suitable agent, being also useful to control the excited circulation and excessive sweating, as well as being sedative to the stomach. In the acute gastro-intestinal disorders of a catarrhal type, especially in the very young who are impressed by the variable weather of the summer season, asclepias in small doses frequently proves a helpful remedy. It is adapted to those of weak constitutions, sensitive stomach, and alternate attacks of diarrhoea or dysentery. These disorders frequently occur in wet seasons, or when a cold, wet spell quickly follows the exhaustive heat of very hot seasons. By aiding the checked perspiration less of a burden is put upon the internal organs, and this is the work which asclepias does. It sometimes relieves flatulent colic in infants and headache in children due to disordered digestion. The fractional doses are preferred.
Asclepias is of special utility in measles for at least three purposes: It alleviates the distressing cough, assists in an early determination of the eruption, and controls the present and after catarrhal phenomena. Though not often thought of in glandular and skin disorders, it is an ideal medicine in mumps and sometimes in mastitis, while for skin affections with excessive cutaneous dryness it assists other agents by its moistening diaphoresis.
Altogether asclepias is one of the most kindly acting and safest agents in the materia medica for one that accomplishes so much. One can scarcely do harm with it.
For pleural pain employ specific medicine asclepias in hot water preferably, using from ten to thirty drops in an ounce of hot water, every half hour, or hour. Carried too far it may cause nausea and vomiting, especially if the doses are large and the water merely warm. For cough and other purposes, employ the specific medicine in the usual way, in cold water, alone or in combination with other indicated agents. As a pectoral and expectorant the compound emetic tincture, which contains asclepias, administered in water, syrup or glycerin, or suitable proportions of either of the latter two with water, is very effectual in dry chronic forms of cough.
The Eclectic Materia Medica, Pharmacology and Therapeutics, 1922, was written by Harvey Wickes Felter, M.D.