The recent root and leaves of Baptisia tinctoria, Robert Brown (Nat. Ord. Leguminosae), a perennial shrub-like plant, indigenous to North America.
Common Names: Wild Indigo, Indigo Weed.
Principal Constituents.—A poisonous alkaloid baptitoxine (baptisine); two glucosides, baptisin, non-poisonous, and baptin, laxative and cathartic; and a yellowish resin. Baptitoxine is identical with cystisine, ulexine, and sophorine, toxic principles found in other active plants, and resembles sparteine in its action upon the heart.
Preparations.—1. Decoctum Baptisiae, Decoction of Baptisia. (Recent root of Baptisia 1 ounce, Water 16 ounces.) Dose, 1 to 4 drachms; employed chiefly as a local application.
2. Specific Medicine Baptisia.—Dose, 1 to 20 drops; as a topical wash or dressing, 1-2 fluidounces to water 16 ounces. Usual form of administration: Rx Specific Medicine Baptisia, 20 drops Water, 4 fluidounces. Sig.: One teaspoonful every 1 to 2 hours.
Specific Indications.—Fullness of tissue, with dusky, leaden, purplish or livid discoloration, tendency to ulceration and decay (gangrene); sepsis, with enfeebled circulation; fetid discharges with atony; stools resembling "prune juice" or fetid "meat washings"; face swollen, bluish, and resembling one having been frozen or long exposed to cold; typhoid conditions.
Action.—Large doses of baptisia may provoke dangerous emetocatharsis, sometimes so violent as to induce gastro-enteritis. The evacuations are soft and mushy, and the effort is often accompanied by a general bodily discomfort or soreness. Profuse viscid ptyalism also occurs. Small doses are laxative; and the drug also appears to stimulate the intestinal glands to secrete more freely and probably increases hepatic secretion. Baptitoxine is said to quicken the breathing and accelerate and strengthen the heart-beat; but in toxic doses it paralyzes the respiratory center, thus causing death by asphyxiation.
Therapy.—External. Locally the decoction and the specific medicine baptisia (diluted with water) are effective as washes and dressings for indolent and fetid as well as for irritable and painful ulcers, inflammations with full or swollen and dusky tissues, and tendency to destruction, aphthous and nursing sore mouth, mercurial gingivitis, sore nipples, and ulceration of the cervix uteri, with foul, sanious, or muco-purulent leucorrhoea. Its internal exhibition hastens its local action in these conditions.
Internal. Internally, baptisia is indicated in pathological conditions characterized by feeble vitality, suppressed or vitiated secretions, and sepsis with a disposition to disintegration and death of tissues. These indications are manifest in the peculiar appearance of the parts affected, of the membranes, and of the patient as a whole. There is a peculiar duskiness of a bluish or purplish hue of the skin and mucous structures, and usually there is fetor. The face has a bluish, swollen appearance, with expressionless countenance, like one who has been long exposed to cold. There may be ulcers of an indolent character, with bluish or purplish edges. The excretions are fetid-those of the bowels being dark and tarry, or resembling the "washings of raw meat or prune juice." Baptisia is not, as a rule, a remedy in acute diseases showing great activity, but rather for disorders showing marked capillary enfeeblement and tendency to ulceration-in fact, a condition of atony. It is contraindicated by hyperaemia; indicated by capillary stasis.
Baptisia is important for its influence upon typhoid conditions. It is quite generally regarded as one of our most effective antityphoid agents. Here we encounter the dusky appearance of the skin and membranes, the sleek, beefy tongue with pasty coating, the fetor of mouth, sordes, upon teeth and lips, and the sluggish capillary flow. Its usefulness in typhoid or enteric fever is one of record. One or more of the foregoing symptoms will be present with the addition of the characteristic pea-soup, meat washings, or prune juice stools, or tar-like viscous evacuations, showing the admixture of decomposed blood. In fact, it is likely to be indicated by any form of persistent diarrhea accompanying this type of fever. Typhomalarial fever, which is most generally predominantly typhoid, is equally influenced for good by baptisia. Typhoid dysentery and typhoid pneumonia, so called, are helped by it just in proportion to the typhoid element present. In dysentery the greater the evidence of intestinal ulceration the stronger the call for baptisia.
For septic conditions other than typhoid, baptisia is distinctly useful. In putrid forms of sore throat, with great stench and full, dusky tissues, the angina of scarlet fever, and tonsillitis, with sluggish circulation and fetid exudate, and also when necrotic, baptisia holds a high rank as a remedy. It is often valuable as an aid in the treatment of diphtheria, but alone should not be relied upon to conquer this vicious disease. When most useful the tissues will be swollen, dusky, or blanched, the secretions free, and the parts sloughing. Indeed, the most important indication for the drug, is the tendency to disintegration of tissues. Baptisia is very valuable in putrid ulcerations of the nasal passages—in fetid catarrh, ozaena, and similar disorders with stench and turgidity. Under these circumstances it overcomes the putrescency, restrains the discharge, and promotes healing of the ulcerated surfaces.
In all of the local disorders mentioned, baptisia should be given internally as well as applied locally.
The Eclectic Materia Medica, Pharmacology and Therapeutics, 1922, was written by Harvey Wickes Felter, M.D.