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Cactus (Selenicereus spp.).

The fresh, green stems and the flowers of Selenicereus grandiflorus (L.) Britt. & Rose (and other Selenicereus species—MM) (Cereus grandiflorus, Miller and DeCandolle.) Native of Mexico and the West Indies; grows also in Italy; cultivated in greenhouses in the United States.
Common Names: Night-blooming Cereus, Large-flowering Cactus, Sweet-scented Cactus.

Principal Constituents.—Cactus has not been satisfactorily analyzed.
Preparation.—Specific Medicine Cactus. Dose, 1 to 10 drops.
Specific Indications.—Impaired heart action, whether feeble, irregular, or tumultuous; cardiac disorders with mental depression, praecordial oppression, and apprehension of danger and death; nervous disorders with feeble heart action; tobacco-heart; hysteria with enfeebled circulation; vertex headache; vaso-motor spasms.

Action.—Cactus impresses the sympathetic nervous system, and is especially active in its power over the cardiac plexus. In sufficiently large doses it acts as an intense irritant to the cardiac ganglia, producing thereby irritability, hyperaesthesia, arrhythmia, spasm and neuralgia of the heart, and even carditis and pericarditis. According to E. M. Hale, M.D., it acts. upon the circular cardiac fibers, whereas digitalis acts upon all the muscular fibers of the heart. Like the latter, as a secondary effect of over-stimulation, it may induce heart-failure. The tincture, in large doses, produces gastric, irritation, and also affects the brain, causing confusion of mind, hallucination, and slight delirium. In excessive doses, a quickened pulse, constrictive headache, or constrictive sensation in the chest, cardiac pain -with palpitation, vertigo, dimness of sight, over-sensitiveness to noises, and a disposition to be sad or to imagine evil, are among its many nervous manifestations. Melancholia often follows such action. It is contended by many that the mental, cerebral, gastric, and other effects are secondary to and dependent largely upon the primary effects of the drug upon the heart; others believe its action depends chiefly upon the nervous system.

Therapy.—Cactus is the remedy for enfeeblement of the heart. An old school writer of prominence has said of it that cactus is the only remedy that will quicken a slow heart. While there are some who declare cactus totally inert as a medicine, there are others who claim for it great value even in structural alterations of the heart. The verdict of Eclectic practitioners, who are the largest users of the drug, is that cactus is a remedy chiefly for functional disorders of the heart due to nervous origin. It is, therefore, a nerve remedy primarily and a heart remedy secondarily. Eclectics have also noted that it improves the nutrition of the heart muscle and thus is, in a measure, a structural remedy also. By improving the nutrition of the organ it is possible, in some instances, to correct structural abnormalities. Valvular troubles have been noted to gradually disappear under its prolonged administration. Unlike digitalis it does not disorder the stomach nor is it cumulative. Cactus acts upon the vessels through the vaso-motor apparatus.

The peculiar state of the nervous system in cardiac diseases, calling for cactus, is quite characteristic. There is a marked mental depression, often amounting to hypochondria and fear of impending death. Associated with these are praecordial weight and oppression and difficult breathing. The control over the nervous system is somewhat like that of pulsatilla, and the effects of cactus are usually permanent.

In medicinal doses, cactus diminishes the frequency of the pulse, and increases the renal secretions, and is, therefore, sedative and diuretic. According to Scudder (Specific Medication), it neither increases nor depresses innervation; that it is neither stimulant nor sedative. Locke, on the other hand, believes it sedative, but not depressant (Syllabus of Materia Medica). In such doses it does not appear to weaken the nervous system in the least.

The special field for cactus is diseases of the heart. Its influence upon the heart is manifested when the disorder is functional; organic conditions are only benefited in a measure. However, some who are antagonists of Eclectic medicine, who are generally skeptical regarding the virtues of plants which do not possess unusually powerful properties, consider cactus as a valuable agent in mitral regurgitation, due to valvular lesions. In our school, however, let us repeat, it is recognized chiefly as a functional remedy, and one of the best of cardiac tonics. There is no doubt but that the continued use of the drug tends to increase cardiac nutrition and waste, and in this way may benefit cases with structural lesions. The influence of cactus is believed to be exerted almost wholly upon the sympathetic nervous system, through the superior cervical ganglia, expending its force in regulating the action of the heart and controlling the cerebral circulation, thus giving increased nutrition to the brain. It is the remedy for most functional cardiac irregularities, as palpitation, pain, cardiac dyspnea, intermission. in rhythm, etc. Even in structural heart-wrongs, the majority of unpleasant symptoms are partly due to disordered innervation, and this condition is corrected by cactus. It does not seem to make any difference whether the heart-action be feeble, violent, or irregular, provided it be due to lack of innervation, associated with mental depression, or in excitable or nervous individuals, the remedy relieves, because its tendency is to promote normal rhythmic action of the cardiac muscle. Aortic regurgitation is nearly always benefited by it and it is useful in progressive valvular weakness, but is contraindicated in stenotic conditions. In spasm of the heart-muscle, and in cardiac pain of a constrictive character, as if the organ were held with a strong band, it is often the most prompt of all cardiac remedies. It is a good remedy in the heart troubles produced by tobacco, probably benefiting oftener than any other medicine.

Cactus is a valuable remedy for the heart symptoms of neurasthenia. During the menstrual period and at the menopause, nervous women frequently experience unpleasant cardiac disturbances of a functional character. These are relieved by cactus. Few agents excel it in menstrual headache, and headache in women with pressure on top of the head. For nervous menstrual headache, Locke recommends: Rx Specific Medicine Cactus, 10-30 drops; Water, 4 fluidounces. Mix. Sig.: Dose, a teaspoonful 3 or 4 times a day. When the heart is enfeebled from long illness, as in convalescence from typhoid or other fevers, cactus is invaluable. Even in incurable conditions of the heart it seldom fails to give some relief. It rarely relieves angina pectoris, and neuralgia of the heart, and is sometimes useful in endocarditis and pericarditis following debilitating diseases. The heart-debility induced by overwork, strains, over-enthusiastic athletes, soldiers on the march and "hikers", and that accompanying or following masturbation finds relief in cactus. When associated with cardiac weakness and irregularities, and in so far as they depend upon these conditions, cactus has been found useful in cerebral congestion, mental derangements, irritable bladder, renal congestion, edematous condition of the limbs, and anasarca. When a vigorous and healthy action of the heart obtains under its use these troubles pass away.

Cactus is recommended in visual defects of an asthenopic character, and in exophthalmic goitre, due to functional heart disease; tinnitus aurium, from the same cause, is benefited by it. These eye and ear disorders are not benefited by it when the cardiac disorder is of an organic nature.

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

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