Preparations: Tincture of Hyoscyamus
- Juice of Henbane
- Extract of Hyoscyamus
- Fluid Extract of Hyoscyamus
- Compound Pills of Hyoscyamus
Related entries: Belladonna.—Belladonna - Duboisia.—Duboisia - Stramonium.—Stramonium
"The leaves and flowering tops of Hyoscyamus niger, Linné," "collected from plants of the second year's growth"—(U. S. P.). Also the seeds of Hyoscyamus niger, Linné.
COMMON NAME: Henbane.
ILLUSTRATION: Bentley and Trimen, Med. Plants, 194.
Botanical Source.—Henbane is a biennial plant, with a long, spindle-shaped, thick and corrugated root, of an internal, whitish color, and externally brown. The stem is from 6 inches to 2 feet high, erect, tapering scarcely branched, and covered closely with long, weak hairs, tipped with a minute black gland. The leaves are large, oblong, acute, alternate, coarsely and unequally sinuated, occasionally somewhat decurrent, stem-clasping at the base, pale dull-green, and slightly pubescent, with long, glandular hairs upon the midrib. The flowers are numerous, axillary, subsolitary, nearly sessile, and embosomed in the uppermost leaves, than which they are much shorter. The corolla is of a dull, dirty yellow, strongly netted with purple veins, deep-purple at the orifice, funnel-shaped, with a somewhat erect, 5-lobed limb; lobes rounded, spreading, the 2 anterior a little smaller than the others, and separated at base by a deep slit in the tube. Calyx villous, funnel-shaped, 5-lobed, regular, wider than the corolla, to whose tube it is equal in length and persistent; each lobe is ovate and acute, with an open aestivation. Stamens 5, declinate, straight, shorter than the corolla, the 3 lower longer than the others; filaments pubescent, inserted about the middle of the tube of the corolla, and inclined; anthers cordate and purple. The ovary is nearly round, shining, pale-green, 2-celled, with numerous ovules, adhering to the dissepiment; style filiform, declinate, and purple at the apex; stigma blunt, round, and capitate. The fruit is an ovate, 2-celled capsule, opening transversely by a convex lid. The seeds are many, small, obovate, and brownish (L.—B.). The whole plant has a disagreeable, fetid odor, and a repulsive appearance.
History.—Henbane is an European herb, naturalized in this country, growing in waste grounds and commons, and flowering from June to September. Botanists are divided as to whether it is an annual or biennial plant. All parts of the plant are medicinal, but the leaves and seeds are the parts usually employed; the former should be collected at the time of its flowering, and the latter when perfectly matured. The leaves of the second year's growth of the plant are reputed more active than those of the first year; when fresh they abound in a viscid juice, and when bruised have a nauseously rank, narcotic smell, and an acrid, oleaginous, disagreeable taste. Upon drying, the smell and taste are almost destroyed. The leaves impart their properties to diluted alcohol; water, alcohol, ether, fixed or volatile oils also take up a portion of their virtues. The aqueous infusion is tasteless, light-yellow, and has the taste and odor of the plant. The leaves should be kept in a dry situation on account of their tendency to absorb moisture.
Description.—HYOSCYAMUS (U. S. P.). "Leaves ovate, or ovate-oblong, up to 25 Cm. (10 inches) long and 10 Cm. (4 inches) broad; sinuate-toothed, the teeth large, oblong or triangular; grayish-green, and, particularly on the lower surface, glandular-hairy; midrib, prominent; flowers nearly sessile, with an urnshaped, 5-toothed calyx, and a light yellow, purple-veined corolla; odor heavy, narcotic; taste bitter and somewhat acrid"—(U. S. P.). For a microscopical examination of powdered hyoscyamus leaves, see Prof. S. E. Jeliffe, in Druggists' Circular, 1899, p. 74.
HYOSCYAMI SEMEN. Hyoscyamus seeds.—The seeds were official in the U. S. P., 1870. They are employed for the production of the alkaloid, hyoscyamine. They are small, numerous, oval, obtuse, or somewhat reniform, compressed, finely dotted, of a yellowish-gray color, and having the same taste and odor as the leaves, but with oiliness. The interior is whitish, displaying within the albumen a figure 9-shaped embryo. The concavity of the seed is marked by the hilum.
Chemical Composition.—According to Morries, an empyreumatic and highly poisonous oil is obtainable by the destructive distillation of henbane (Edin. Med. and Surg. Jour., Vol. XXXIX, p. 379), The chief constituents of hyoscyamus seeds, besides fixed oil and fatty matter, gum, starch, albuminous matter, etc., are two alkaloids, hyoscyamine and hyoscine, the latter having been recognized, in 1880, by Ladenburg (Lieb. Ann., Vol. CCVI, p. 279), and previously (1876) observed by Buchheim, and called by him sikeranine. Mr. F. Mahla obtained nearly 2 per cent of nitrate of potassium from the leaves of henbane (Amer. Jour. Pharm., 1859, p. 402).
HYOSCYAMINE (C17H23NO3, Ladenburg), was found in henbane (impure) by Peschier (1821) and by Payen (1824), and subsequently purified by Geiger and Hesse (1833). It is more abundant in the seeds than in the herb, the latter when fresh, yielding 0.14 to 0.16 per cent; in the fresh seeds Wadgymar (Proc. Amer. Pharm. Assoc., 1867, p. 404), found as high as 0.52 per cent of the alkaloid. (For a summary review of the various methods pursued in isolating hyoscyamine, see Husemann and Hilger, Pflanzenstoffe, 1181.) In purest form it is obtainable from its (purified) gold double chloride (Ladenburg). Pure hyoscyamine crystallizes in tufts or stellate, silky needles of an acrid, unpleasant taste; when impure it is an amorphous, deliquescent mass, having a nauseating, narcotic, tobacco-like smell. It dissolves sparingly in cold, more readily in hot water, is soluble in alcohol, ether, chloroform, benzol, and amyl alcohol. Its melting point is 108.5° C. (227.3° F.). Hyoscyamine is strongly basic and forms crystallizable salts with acids. In aqueous solution it is very unstable, being decomposed by heat, especially when heated with alkalies, ammonia then being liberated. Ladenburg proved it to be an isomer of atropine (which see), yielding the same decomposition products (tropine and tropic acid) as atropine when heated with diluted hydrochloric acid or baryta water. From solutions of its salts, hyoscyamine is but incompletely precipitated by caustic alkalies or carbonates; it forms precipitates with auric chloride, tincture of iodine, tannic acid, and other alkaloidal reagents. The platinic double chloride is more soluble than that of atropine. This behavior permits its isolation from commercial (impure) atropine. Hyoscyamine is identical with duboisine from Duboisia myoporoides (Ladenburg), and is likewise identical with daturine (see Merck's Index, 1896). Hyoscyamine is an active poison, as are its salts; a minute quantity of it placed within the eye, causes a persistent dilatation of the pupil.
Hyoscine (C17H21NO4, O. Hesse and E. Schmidt). This base was obtained by Ladenburg from commercial semi-liquid brown hyoscyamine by dissolving it in water, precipitating with gold chloride, and recrystallizing from hot water, from which solution hyoscine gold chloride first precipitates, and the base is then easily regenerated. Hyoscine forms an amorphous, semi-liquid mass, not easily soluble in water, easily soluble in alcohol and ether. It yields crystallizable salts with acids, and on warming with baryta water at a temperature of 60° C. (140° F.), is decomposed into tropic acid (C9H10O3), and pseudo-tropine (C8H15NO). A water soluble hyoscine was recently found by O. Hesse to be obtainable in comparatively large quantities from the flowers of Datura alba, an ornamental plant cultivated in southern Germany (Druggists' Circular, 1899, p. 85).
Action, Medical Uses, and Dosage.—Hyoscyamus is a powerful narcotic, and is dangerously poisonous, though fatalities from it or its alkaloids are rare. In fact, the physiological action of henbane and its bases scarcely differs from that of stramonium and belladonna and their alkaloids, except in degree. It produces the same dryness of the mouth, flushing of the face, pupillary dilatation, quickened cardiac and respiratory action, illusions, hallucinations, and delirium occasioned by belladonna, only in a lesser degree. No difference is observable in the action of hyoscyamine and atropine upon the mechanism of accommodation and upon the movements of the lungs and heart. Hyoscyamine is more hypnotic and less apt to cause delirium than atropine. The dilatation of the pupils, which, however, does not always take place under hyoscyamine, is caused by stimulation of the sympathetic nerves. When death occurs from hyoscyamus or its alkaloids it is due to respiratory paralysis. The alkaloids are eliminated by the kidneys. In large doses, but insufficient to produce death, the tendency of hyoscyamus is to produce general paralysis of the nervous structures. One patient lost her memory from being poisoned with it. Among the ill effects of hyoscyamus are: Deranged vision, dilatation of the pupils, giddiness, general excitation, fullness of pulse, flushing of the face, weight in the head, headache, loss of muscular control, with tremulousness, mental confusion, incoherency or loss of speech, somnolency, furious delirium, unconsciousness, coma, irresponsiveness of the pupils to light, cold sweat, small, frequent, and feeble pulse, and deep and labored respiration. Tetanic rigidity may be present a portion of the time and sometimes convulsions, as well as nausea, vomiting, and intestinal pain and purging. The treatment of poisoning by hyoscyamus is that indicated under Belladonna. Chloral is especially recommended for poisoning by hyoscine. Autopsies reveal gastro-intestinal inflammation from poisoning by this drug.
When 1/15 of a grain of sulphate of hyoscyamine has been subcutaneously injected hyoscyamine has been detected in the urine 22 minutes afterward. If enough be injected to cause complete dryness of the tongue and hard and soft palates, the pulse will increase temporarily in frequency, volume, and power; if this effect upon the tongue is not produced, the pulse will be lessened in frequency without diminution of its volume and force, and giddiness, somnolency, and dilatation of the pupils will accompany, the patient frequently acting as if intoxicated (Harley). (Compare Atropinae Sulphas and Duboisia.)
Hyoscyamus is a cerebro-spinal stimulant, or in the Eclectic meaning of the term, a cerebro-spinal sedative. It relieves pain and promotes sleep. Nervous irritation, without congestion, high fever, or disturbance of the circulation in the cerebrum is the key-note to its use. Functional disturbances are those best relieved by the smaller doses of hyoscyamus. In medicinal doses it is anodyne, hypnotic, calmative, and antispasmodic; allaying pain, soothing excitability, inducing sleep, and arresting spasm. It does not produce constipation like opium, but has a tendency to act as a laxative. Its sedative effect upon the sympathetic nervous system requires larger doses to produce, and it is more transient and less powerful than belladonna; its most prominent effects are excessive giddiness and somnolency, which is caused by belladonna in only a very secondary degree. Hyoscyamus is a far safer agent for children and old people than opium. It favors the restoration of the normal functions when impaired through nerve irritability or debility. In this way it often favors the action of the special sedatives. If there is irritation of the gastro-intestinal tract it improves the action of the bitter tonics. As a remedy for pain it is less efficient than opium, and usually requires larger doses. Unlike the latter, it does not restrain the secretions.
Hyoscyamus is usually given in cases where opium disagrees, or where constipation must be avoided; in neuralgic and all spasmodic affections, as renal, uterine, hepatic and flatulent colic, asthma, gout, rheumatism, chronic cough, irritations of the urinary organs, and inflammatory cases attended with nervous excitability and not with high fever. On account of not producing headache, it is preferred to opium in hepatic and renal inflammations, and to relieve pain and lessen cough in pulmonic affections. In bronchitis with short, dry, explosive cough, it is a very useful agent, and in pneumonia we have obtained prompt results from small doses, when a condition of sub-delirium with widely dilated pupils was present. Dry, irritative cough and the troublesome nervous cough, so-called, aggravated by lying down, are indications for hyoscyamus. As a cough remedy, it is frequently given with syrup of wild cherry, and in this form renders excellent service in phthisis. It often renders good service in spasmodic asthma, and it should be remembered as an important remedy in whooping-cough.
Hyoscyamus is a remedy for spasm and pain—particularly for spasmodic pain. When there is nervous irritation, feeble circulation, and tendency to mental aberrations, it is particularly useful in the neuralgia of exhaustion, syphilitic bone-pains, dysmenorrhoea, particularly when neuralgic, menstrual headache, headache of debility, and the pains of herpes zoster, pains in the liver, kidneys, bladder, ovaries, etc. All these cases when showing anemia and nervous depression, will yield to hyoscyamus or its alkaloids. Great unrest, with debility, is relieved by this drug. Hyoscyamus is an excellent agent in irritable conditions of the bladder and urethra, where nerve force is low, and should therefore find a place in urinal urging, tenesmic voiding, and in nocturnal as well as diurnal incontinence. It is a urethral sedative, and combined with camphor (pill) has long been employed to relieve urethral irritation after the passing of bougies, catheters, sounds, and divulsors. The pains of hemorrhoids are frequently relieved by this agent. Hyoscyamus is frequently combined with active cathartics, as scammony, colocynth, aloes, resin of podophyllin, etc., without impairing their energy, not only for preventing tormina, but because it renders their action more efficient.
The great field for hyoscyamus and its alkaloids is in nervous affections, and here its principal employment is to cause sleep, or remove irregular nervous action. They are useful in irritable conditions of the brain and heart, with palpitation, and in certain cases of epilepsy, chorea, senile and mercurial tremors, and enuresis. Brown-Sequard says that hyoscyamus should be used instead of belladonna or opium, in cases of paraplegia, with symptoms of irritation of the spinal cord, where sleeplessness is present. To force sleep in insomnia, narcotic doses are required, and, as a rule, such an action is undesirable, and other agents are better for this purpose. But to allay irritability, upon which sleeplessness often depends, or to relieve restlessness and dreaming during sleep, no drug is more efficient than hyoscyamus, in small doses. It is often useful in children's diseases for this purpose. In fractional doses, it is an excellent calmative in typhomania of typhoid fever. It is serviceable in hysteria, with frequent voiding of small quantities of urine. Fractional doses of hyoscyamus, frequently administered are useful in "puerperal convulsions, associated with a nervous condition bordering on mania" (Locke).
Few remedies have been more valued in the treatment of the various forms of insanity than hyoscyamus and its alkaloids. It is especially useful in mania, both acute and chronic, larger doses being usually required in the latter form. The cases most benefited are those exhibiting great excitation, with a tendency to destructiveness, delusional insanity, epileptic mania, and recurrent mania. Prof. Webster mentions as a strong indication for hyoscyamus the garrulousness and quarrelsomeness exhibited by the insane. Nervous disturbances manifested by low muttering delirium, or by singing and talkativeness during fevers, are frequently relieved by small doses of this agent. Hyoscyamus has been declared useless in delirium tremens, but there is abundant reliable evidence to prove that it is an exceedingly useful agent when that malady is not of the most active character, and the victim is given to low muttering delirium. Here stimulant doses sufficient to sustain the nervous system should be given.
Hyoscyamus should not be overlooked as a calmative in nymphomania, particularly if due to childbirth, when there is evidently more delirium than sexual passion; the circulation is feeble, the pulse quick and small, the brain active, and the patient may have been disturbed with unpleasant dreams. Puerperal mania, due to exhaustion and weakness, is often controlled by hyoscyamus. It acts well in the insomnia of exhaustion, where there is continual agitation and nervous unrest. Hyoscyamus is especially valuable to control the nervous phenomena following fevers and other exhausting diseases. Nervous heart action is amenable to it, as is also tumultuous heart-action, with valvular insufficiency.
Where the fresh leaves can be obtained, they are employed in fomentation, or bruised, as an external application to allay the inflammatory and painful condition of ulcers and tumors, as well as to relieve nervous headache, and the pain in gouty, neuralgic, rheumatic, and similar affections. An ointment of hyoscyamus extract (ℨi to petrolatum ℨj), is useful to relieve pain in hemorrhoids, cancer, etc. A liniment for glandular swellings may be made by mixing together, extract of henbane, 1 drachm; white soap, 4 drachms, and linseed oil, 12 fluid ounces; to be applied 2 or 3 times a day with considerable friction. Dose of the powdered leaves, from 2 to 10 grains; of the tincture, from 30 drops to 2 fluid drachms; and of the alcoholic extract, which, is the only extract that should be used, from ½ to 2 grains, which may be cautiously increased, according to its effects; of specific hyoscyamus, fraction of a drop to 20 drops. It should be remembered that the administration should begin with the smaller doses, and that patients become tolerant of its action so that enormous doses may be given. For the specific action, however, only small doses are required.
HYOSCYAMINE AND HYOSCINE (SCOPOLAMINE).—The two alkaloids of hyoscyamus—hyoscyamine and hyoscine—or their salts, chiefly the hydrobromates, are frequently given in the nervous disorders above mentioned, hyoscyamine salts being preferred to those of hyoscine, as the latter are said to sometimes produce mental excitation. From the fact that much of the so-called "amorphous hyoscyamine," the most active kind, is frequently largely contaminated with hyoscine, it has been extremely difficult to determine the exact field of action of each, or the proper doses. Hyoscine is much more active than hyoscyamine, the ordinary hypodermatic dose ranging from 1/300 to 1/100 grain, though even in these doses it should be cautiously employed. The hydrobromate of hyoscyamine may be given in much larger doses. Hyoscine hydrobromate and hyoscyamine hydrobromate have been especially employed in acute mania, epileptic mania, delusional insanity, chronic dementia, chronic alcoholism, paralysis agitans, sexual excitation with seminal emissions (1/120 to 1/80 grain at bedtime), nymphomania, whooping-cough, enteralgia, spasmodic asthma, spasmodic torticollis, facial neuralgia, insomnia, Profuse sweating, tetany, tetanus, neurasthenia of hypochondriasis, etc. Hyoscine has been used to cure the morphine habit.
As a mydriatic, hyoscine is more powerful and more prompt than atropine, but the dilatation produced is less prolonged; accommodation, however, is slowly recovered. The hydrobromate is the form generally employed, being used in the cases in which atropine is apparently indicated, but when the latter gives rise to atropine irritation. The solutions generally employed are those containing from 2 to 4 to 8 grains to the ounce of distilled water. Scopolamine (see Scopolia atropoides (not found in this Dispensatory, except as a short note under Atropa)), is now recognized as practically identical with hyoscine, the German Pharmacopoeia having adopted the name Scopolamine Hydrobromate for hyoscine hydrobromate, from the fact that most of the hyoscine is now prepared from Scopolia atropoides, it yielding larger amounts than other hyoscine-yielding species. One drop of a 1 to 3000 aqueous solution of scopolamine hydrobromate produces complete dilatation of the pupils in ¼ hour, and maintains the dilatation for 2 days. A drop of 1 to 20,000 aqueous solution will produce a partial dilatation in 20 minutes (Murrell). Scopolamine may be employed for accommodation paralysis by applying 1 drop only by means of a glass rod. For examining for errors of refraction 1 drop of a solution of about ¼ grain to 1 fluid ounce of water is preferred. The lids should be rubbed outward to prevent the fluid from entering the ducts. Several cases of most profound poisoning have resulted from the use of even weak solutions of this mydriatic, therefore its action should be closely watched (Prof. W. B. Scudder, M. D.).
The leaves of hyoscyamus in infusion, or the extract dissolved in water, were formerly used locally to the eye before operating for cataract, in order to dilate the pupil, which is usually effected in 3 or 4 hours, without any subsequent injury to the eye. This was succeeded by the use of hyoscyamine and its salts, which have now given way to hyoscine hydrobromate; occasionally hyoscine hydriodate is used for the same purpose.
As to the dosage of the alkaloids, hyoscamine and hyoscine and their salts, there has been much variance, particularly in regard to the former, which in commerce is often of greatly variable strength. Hyoscyamine has been given in doses as large as 1 grain, but the ordinary commencing dose should not be larger than 1/70 grain, gradually increased until the desired action is obtained. Hyoscyamine sulphate, 1/130 to 1/40 grain; by instillation into eye, 1/40 to 1/20 grain; hyoscyamine hydrobromate, 1/150 to 1/50 grain; by instillation into the eye, 1/40 to 1/20 grain; hyoscine hydrobromate, 1/150 to 1/80 grain; to eye, ½ to 1 per cent solution; hypodermatically, 1/300 to 1/100 grain. As a general rule the hypodermatic dose of these salts is one-half or less than one-half as small as when given by mouth. Particularly should care be exercised in the case of the hyoscine salts, the preferred doses of which are those of 1/300 to 1/100 grain.
Specific Indications and Uses.—Nervous irritability, with unrest and insomnia; face flushed and pupils dilated; fright, terror, restlessness in sleep; loquaciousness; busy delirium of a low muttering character, or with singing, talkativeness, amusing hallucinations and illusions, etc.; garrulousness; destructiveness; sharp, dry, nervous cough, worse upon assuming a recumbent position muscular spasms; choking sensations; rapid and palpitating cardiac action.
Preparations Containing Hyoscyamus.—BALSAMUM TRANQUILLANS. The French Codex has a preparation of the above name made by treating narcotic and aromatic plants with olive oil to extract their active constituents. It is used as a local application for pain. A modified preparation has been used in this country. Take 60 grains of each of the alcoholic extracts of belladonna, hyoscyamus, conium, and stramonium, and 24 grains of aqueous extract of opium. Add 2 fluid ounces of boiling water to soften the extracts, and add olive oil, 8 fluid ounces. Digest with moderate heat until the water is dissipated, and filter. Add to the filtrate 20 minims each of the essential oils of lavender, sage, peppermint, thyme, wormwood, and rue. It is a good application in earache, a few drops being introduced upon cotton into the external auditory meatus. Care should be observed in its use.
OLEUM HYOSCYAMI COMPOSITUM (N. F.), Compound oil of hyoscyamus, Balsamum tranquillans.—"Oil of absinth, oil of lavender, oil of rosemary, oil of sage, oil of thyme, of each, 2 drops; infused oil of hyoscyamus (F. 279), one hundred cubic centimeters (100 Cc.) [3 fl℥, 183♏]. Mix them. Note.—Oil of absinth is the volatile oil of Artemisia Absinthium, Linné (wormwood), and oil of sage is the volatile oil of Salvia officinalis, Linné. Infused oil of hyoscyamus is the Oleum Hyoscyami of the German Pharmacopoeia. The Baume Tranquille (Balsamum Tranquillans) of the Codex is a more complex preparation, not identical with the above, but possessing about the same properties"—(Nat. Form.). This and the preceding preparation may he employed as embrocations for the relief of neuralgic, myalgic and rheumatic pains.