The rhizome and rootlets of Helleborus niger, Linné.
COMMON NAMES: Black hellebore, Christmas rose.
ILLUSTRATIONS: Bentley and Trimen, Med. Plants, 2; Woodville, Med. Bot., 169.
Botanical Source.—Black hellebore has a black, perennial, tuberculated, horizontal, scaly root or rhizome, whitish internally, and sending off numerous, long, fleshy, brownish-yellow fibers, which become darker upon drying. Its leaves are large, radical, on cylindrical stalks from 4 to 8 inches long, pedate, of a deep-green color above, and paler and strongly reticulated beneath; leaflets 5 or more, 1 terminal, cuneate-obovate, entire and unequal at the base, and coarsely serrated near the point. The scape is shorter than the petiole, 1 or 2-flowered, with ovate lacerated bracts immediately beneath the calyx, and 5 or 10 inches high. The flowers are large and rose-like. The calyx consists of 5 large, ovate or roundish, spreading sepals, at first white, then rose-red, eventually becoming green. The petals are yellowish-green, tubular, shorter than the stamens, and narrowed to the base; stamens numerous; anthers yellow; capsules leathery; seeds many, arranged in 2 rows, elliptical, umbilicated, black, and glossy (L.).
History and Description.—Black hellebore inhabits the subalpine woodland regions in the middle and southern parts of Europe, flowering between December and February; it is also called Christmas rose. It is not the Melampodium of the ancients, so celebrated in mental diseases, which is now shown to be a distinct species, the Helleborus orientalis, and which probably possesses similar medicinal virtues as well as do the roots of some other species of the same genus. Another species should be mentioned here on account of its rhizome having a commercial name liable to become confused with Veratrum viride (green hellebore). It is the Helleborus viridis, Linné. The commercial name of the drug (rhizome and rootlets), is Radix hellebori viridis, or green hellebore root. This species is regarded by some as more useful than the black hellebore, and has consequently obtained official recognition in Europe. The medicinal parts of hellebore are the radicles or root fibers, which are generally met with the rhizome attached. It is a many-headed root with a caudex or body seldom over ½ inch in thickness, and several inches long, horizontal, sometimes contorted, uneven, knotty, with transverse ridges, slightly striated longitudinally, its upper surface having the remains of the leaf and flower-stalks, and thickly beset upon the sides and under surface with fibers, which, when uninjured, are from 3 inches to a foot in length, 2 or 3 lines in diameter, dark brownish-black externally, whitish within, spongy, not woody, brittle, with a feeble odor, and a faint, bitter taste (C.). When fresh they are said to be very acrid and nauseous, occasioning, when chewed for a short time a pungent, numb sensation, resembling that which accompanies the eating or drinking of anything hot. Desiccation, as well as age, gradually lessens this acridity. Its properties are taken up by water or alcohol; long-continued heat diminishes its activity.
The rhizomes of Adonis vernalis, Linné, and Actaea spicata, Linné, of Europe, have been employed as adulterants of black hellebore.
Chemical Composition.—The root and the root-leaves of the various species of Helleborus contain two glucosids, helleborein, which is a cardiac poison, also having drastic powers, and helleborin, a narcotic poison; also fatty oil, acrid resins, etc., but no tannin. Helleborus viridis is stated to yield a more active helleborein than H. niger; the same plant yields the largest amount of helleborin (0.04 per cent). Helleborein was discovered in 1864 by Husemann and Marmé (Ann. Chem. Pharm., Vol. CXXXV, p. 55). These authors also studied more closely the helleborin discovered in 1853 by Bastick (Pharm. Jour. Trans.). Both substances were carefully investigated quite recently by K. Thaeter (Archiv der Pharm., 1898, pp. 414-424). The isolation of the two substances from the root was effected by means of their opposite behavior toward water and ether, helleborein being freely soluble in water, but insoluble in ether, while helleborin is insoluble in water and soluble in ether.
HELLEBOREIN crystallizes from absolute alcohol in fine needles, which are not hygroscopic when pure; it is of a sweetish taste, and in powder form bag sternutatory properties. Its aqueous solution is precipitated by mercurous nitrate, tannic acid, etc. On boiling with diluted acids, it is decomposed into sugar and dark blue flakes of helleboretin, which are insoluble in water and ether, but soluble in alcohol with violet color (Husemann and Marmé). K. Thaeter has quantitatively established the mechanism of this reaction, in which 2 molecules of dextrose and 3 molecules of acetic acid are formed, the equation being as follows: C37H56O18 (helleborein) +5H2O=C19H30O5. (helleboretin) +2C6H12O6+3C2H4O2. Helleboretin is permanent toward hot diluted acids, and is a member of the fatty series of organic compounds. Concentrated nitric acid produces with helleboretin a characteristic deep-violet color which, on dilution with water, is permanent for some time. Thus the formation of blue flakes upon boiling with acids, and the subsequent color reaction with nitric acid may serve as a characteristic test for helleborein.
HELLEBORIN.—K. Thaeter confirmed all the properties found by Husemann and Marmé for this substance, except its formula, for which he finds (C6H10O)n, while his predecessors arrived at the formula C36H42O6. This substance forms white, odorless, and tasteless needles, but in alcoholic solution they impart an acrid taste. It is insoluble in cold water, quite soluble in alcohol and chloroform. Prolonged boiling with diluted acids decomposes it into sugar and helleboresin (C30H38O4). Helleborin gives a characteristic violet-red color with concentrated sulphuric acid; when poured into water white flakes are precipitated.
Action, Medical Uses, and Dosage.—Black hellebore is a drastic cathartic, and is reputed to possess emmenagogue powers, but the latter is probably due to its purgative effects. In smaller doses it is a cardiac stimulant, and diuretic and anthelmintic properties are also ascribed to it. In large doses, it is a powerful poison, causing gastro-intestinal inflammation, dizziness, painful spasms, severe emesis, catharsis, heart failure, dilatation of the pupils, thirst with abdominal heat, cold sweats, convulsions, and even death. Death occurs from spasms and exhaustion. The recent root produces rubefaction, and sometimes blisters, when held in contact with the skin. Hellebore was formerly used in palsy, insanity, apoplexy, dropsy, epilepsy, etc., but is seldom used at present; occasionally it is found useful in chlorosis, amenorrhoea, etc. In nervous disorders it might still be used, if properly employed, in cases of melancholia and mania when due to gastro-hepatic disturbances, or in acute forms of mental aberrations due to menstrual wrongs. Hysteria and hypochondria may be benefited by it, especially when dependent upon abdominal wrongs. As an agent for dropsy, it is regarded as less useful than apocynum. It has been used to reduce dropsy through its purgative action, but since it has been found that small doses of the drug tend to stimulate the heart and increase diuresis, there is reason to believe that we have not yet fully appreciated the power of the drug. Dropsies due to atonic states of the bowels, serous effusion after inflammations, with deficient absorption, and hydro-thorax and anasarca following the specific eruptive diseases, are specially mentioned as coming within its curative power. The dose for this purpose should be from a fraction of a drop to 5 drops of specific hellebore. Bryonia, apocynum, and digitalis act well with it.
The drug in small doses increases the force of the heart's contraction, slows the pulse, and increases arterial tension. Renal activity is increased under its action, and non-compensatory symptoms in heart affections have rapidly disappeared under the use of this drug. Prof. Scudder (Spec. Med.) suggests it as an emmenagogue when the patient is annoyed by heat flashes, burning of the surface of the thighs and nates, and sensitiveness of the pelvic and perineal tissues. It has been used in bowel disorders with jelly-like passages. The agent requires and deserves restudy. For the specific uses the minute dose is preferable. Rx Specific helleborus niger gtt. v, aqua fl℥iv. Mix. Sig. Dose, a teaspoonful every 1, 2, or 3 hours. For its old uses as a drastic purgative, etc., the dose of the powder is from 5 to 10 grains; of the tincture, from 1 to 2 fluid drachms; of the extract, 2 to 5 grains.
Helleborein, besides possessing similar properties, has been found to be a depressant of the nervous functions, and to possess decided anaesthetic properties. From the fact that it has no apparent effect upon the pupil, nor affects the intra-ocular tension, it has been preferred by some over cocaine as a local anaesthetic in eye diseases, and is reputed more permanent in its effects than the latter. From 3 to 4 drops of a solution, representing in all from 1/55 to 1/40 grain, is thus employed. Owing to its powerful action upon the heart, it is not used subcutaneously to produce local anaesthesia.
Specific Indications and Uses.—(The minute doses only.) Dropsy; heavy feeling in head, with cold forehead and clammy sweat; amenorrhoea, with flashes of heat, burning of surface of thighs and buttocks, and pelvic and perineal sensitiveness; discharges of gelatinous mucus from the bowels.
Related Species.—Helleborus foetidus. Bear's foot. This European perennial, of fetid odor, is the most active of the hellebores. The acrid, bitterish, and pungent leaves and stem-stalks, when chewed, excoriate the membranes of the mouth. It acts as a powerful emetic and purgative, and in large doses is a dangerous agent. It has been used in powder and decoction to expel tapeworm, and in asthma, hypochondriasis, and hysteria. Dose of the drug, from 5 to 20 grains; of the decoction (13 of drug to 8 fl℥ of water), a fluid ounce. It contains the same constituents as hellebore. Therapeutically, it is scarcely known in this country.