The Differential Therapeutics of Veratrum and Aconite.
Selected writings of John M. Scudder.
This editorial is a selection from among many others of equal force showing the methods of study and the clearness with which he taught the specific uses of medicines. Note that conditions rather than diseases form the basis of his system of diagnosis. Contrast this method with that of the older, and to some extent the text-books of to-day which teach the use of drugs in asthma, pneumonia, croup, etc., without further elucidation, and draw your conclusions as to which method would inspire the greater courage and certainty in the use of medicines. See also editorial on "Why Do We Use the Term Specific?"—Ed. Gleaner.
THE DIFFERENTIAL THERAPEUTICS OF VERATRUM AND ACONITE.—To determine which of a class of remedies is applicable in a given case is the most difficult task of the physician, and any information in this respect is of much value. I doubt whether any one using the two remedies named would be willing to risk giving this estimate. Many may have an empirical intuition in regard to it, but most could venture nothing but a guess.
In general terms, veratrum is the remedy in sthenia, aconite in asthenia, but there are too many exceptions to this to make it a safe rule for our guidance.
Veratrum is the remedy when there is a frequent but free circulation. It is also the remedy when there is an active capillary circulation, both in fever and inflammation. A full and bounding pulse, a full and hard pulse, and a corded or wiry pulse, if associated with inflammation of serous tissues, call for this remedy.
Aconite is the remedy when there is difficulty in the capillary circulation, a dilatation and want of tonicity of these vessels, both in fever and inflammation.
It is the remedy for the frequent, small pulse, the hard and wiry pulse (except in the cases above named) the frequent, open, and easily compressed pulse, the rebounding pulse, the irregular pulse, and indeed wherever there is the evidence of marked enfeeblement of the circulation.
It is the sedative I associate with belladonna in congestion, especially of the nerve centers, and to relieve coma. Whilst I would use veratrum with gelsemium in determination of blood to the brain, and in active delirium.
Veratrum acts more efficiently upon the excretory organs; indeed, I believe it to be one of the most certain remedies we have to increase excretion. Hence it is employed with great advantage for those purposes usually called alterative.
Aconite controls excessive activity of the excretory organs, whether of the bowels, kidneys, or skin. Thus it is our most certain remedy in the summer complaint of children, associated with belladonna in diabetes insipidus, with the bitter tonics and strychnia in phosphuria and oxaluria, and with the mineral acids in night sweats.—SCUDDER, Eclectic Medical Journal, 1868.