Lobelia Inflata. Lobelia, Emetic Weed.
Indian Tobacco, Eyebright.
Description: Natural Order, Lobeliaceae. In this group are the brilliant scarlet and large blue cardinal flowers, with two small species cultivated for hanging baskets. All the species are common in every section of North America–the family being named in honor of the English Botanist, Mathias de Lobel. Genus LOBELIA: Herbaceous plants, with alternate and ex-stipulate leaves. Flowers axillary and solitary; calyx five-lobed: corolla tubular, somewhat two-lipped, cleft nearly to the base on the upper side, upper lip of two separate lobes, lower one three-lobed; stamens five, the anthers united in a curved tube; style one, with a two-lobed stigma–the latter surrounded by a minute fringe. Fruit a two or three-celled capsule, opening at the summit, with numerous small seeds. L. INFLATA: Stem erect, six to twenty inches high, unbranched; in good soil usually branched above, and attaining a height of two feet or more: somewhat angled, and a little hairy. Leaves sessile, scattered, elliptical or ovate-lanceolate, serrate, veined, hairy or pilose beneath. Flowers in leafy terminal racemes, on short peduncles; corolla small, pale blue, inconspicuous. Fruit an inflated and thin capsule, crowned with the persistent calyx, striated, two-celled, ten-angled; seeds small, (one-thirtieth of an inch in length,) dark-brown, almond- shaped, oily. This plant is annual in warm latitudes, but biennial in the Middle and Northern States, blooming from July to September. It prefers meadows, pastures, roadsides, and other grassy places, where the soil is gravelly and not too rich.
History: This herb has had to fight its way into use through opposition the most extended and bitter; and has had combined against it the deepest venom of the whole one hundred and fifty thousand Allopathic physicians in this country, who in turn brought to their help the prejudices and passions of the people, and the power of legislative enactments. Enmity so malignant has scarcely been equaled in medical history. Although the "regular" profession has too often marred its name by the blindness with which it has opposed every step in medical progress–reducing Harvey to beggary for discovering the circulation of the blood, crushing Jenner into the vilest disgrace for introducing the practice of vaccination, heaping the coarsest obloquy upon Pare and others for tying arteries instead of plunging the bleeding stumps into scalding tar, cursing Peruvian bark as a pestilence and a device of the devil–it would seem as if the concentrated malignity of ages had been gathered up in its ranks, that it might be heaped upon this valuable medicine. In this as in all other cases, the more beneficial the article promises to be to the world, the more deep and bitter the Allopathic opposition. As Prof. M. Paine says of the introduction of cinchona, (p. 349,) "We see in the nature of the hostility waged by a great part of the profession against this invaluable remedial agent, and in the very face of its triumphant success, a disposition to trample on the best interests of society, when professional pride, or cunning jealousy, or malevolent envy, may hope for gain." The innumerable instances in which similar hatred has "trampled on the best interests of society," should be sufficient to deter such intelligent gentlemen as Profs. Paine, Wood, Griffith, Stille, Pereira, Taylor, Christison, and hosts of others, from lending themselves to a repetition of that "malevolent envy" which would crush out the truth in order to warm its own "professional pride" on the ashes.
All Allopathic authors who allude to the origin of the professional use of this article, ascribe its introduction to Rev. Dr. Cutler, of Massachusetts; who testified, in the fall of 1809, to having cured himself of asthma by its use in September of that year. The first professional attempt to give an account of its action, was that made by Dr. Thatcher, of Boston, in his Dispensatory published in 1817. This account was a remarkably incorrect one; and, from a medical standpoint, was of no use in showing the true nature of the plant. Thatcher and others say that the article was in use among the Penobscot Indians from a very early day; and this may have been the case, though the fact was never named till 1810–a year after the trial of Dr. S. Thomson for producing death by its use. There seems reason to believe that its emetic qualities were known in some portions of New England quite early in the present century; but no evidence that that action was known to, or was used by, the medical profession. To Dr. Samuel Thomson is unquestionably due the credit of first clearly defining its qualities and employing it for definite medical purposes. As early as 1773, he became aware of its power to procure vomiting; and from that time till 1791, frequently gave it to his young companions for amusement. During 1791, he first became practically acquainted with its ability to afford relief in disease; from that date, he resorted to it in colic, rheumatism, fever, and many other complaints; and by 1805 had made himself famous over a large portion of New England for the marvelous quickness with which he cured scarlet fever, putrid sore-throat, erysipelas, dropsy, and other very severe maladies, by the use of this and other remedies. From 1805 onward he repeatedly cured the most unpromising cases of asthma with this agent, and that in the immediate neighborhood of the above Dr. Cutler; but it was not till 1809 that Dr. Cutler claimed ever to have used it in asthma, and then he knew nothing of its value in other cases. Thus for several years before Dr. Cutler used this remedy, according to his own testimony in court, Dr. Thomson employed it extensively in various places through Vermont, New Hampshire, New York, and Massachusetts. And he thoroughly understood the relaxant, diaphoretic, emetic, and nervine qualities of this agent as early as 1795, while Dr. Thatcher did not write his account of it till 1817; and that account was utterly incorrect, and in no sense descriptive of the action of the article except in the single malady asthma, as made known to Dr. Thatcher by Dr..Cutler in 1810. And the account in Dr. Thatcher's Dispensatory of 1817 bears evidence of having been written solely to bring disrepute on the practice which Dr. Thomson was compelled to protect by letters patent in 1813. These are current matters of fact in the prints of those dates, and clearly bestow upon Dr. Thomson the credit of first learning and employing this article in the wide range of maladies to which it is applicable. If the Penobscot Indians and some of the New England settlers did know of it, the information was assuredly kept to themselves; as there is no proof that the knowledge was common, no printed or written evidence in support of the assertion prior to 1810, and none whatever that Dr. Thomson ever heard of others being acquainted with it. He himself solemnly declares that no intimation of its virtues ever came to him from any source, but that he learned its value by his own perseverance in observations and experiments; and the sterling character of that much-persecuted man lifts his veracity above question. Prof. B. Waterhouse, in a letter of introduction given to Dr. Thomson to present to Prof. B. Mitchell, of New York, dated at Cambridge, December 19, 1825, says: "Dr. Samuel Thomson has the honor of introducing the valuable lobelia to use, and fully proved its efficacy and safety." Prof. Waterhouse lived at a time when and in a place where it could easily be ascertained to whom the honor of this discovery belonged. He had all the pride of his professional position to gratify by denying it to Dr. Thomson; and his unqualified language in giving the credit of discovery to Thomson, even if all other evidence of the fact were wanting, should forever silence those little pettifoggers who would now rob that noble man's name of his dues. The attempt of Allopathy, even in high places, now to wrest from him the honor of making a discovery for which that same Allopathy so maliciously persecuted him, is far from being creditable to those partisan writers who would ignore printed history to gratify their "malevolent envy."
As early as 1817, Dr. Bigelow, in his Medical Botany, alludes to the trial of Dr. S. Thomson for the murder of Ezra Lovett by the use of lobelia, giving a horrible account of the doctor's proceedings, and saying that this "empiric" and "pretending physician" "thus terminated the disease and the patient at once." A similar statement was made in Thatcher's Dispensatory, the same year. From that date to the present, it is probable that every Allopathic Materia Medica that mentions lobelia, contains the assertion that Thomson was tried for committing murder by the use of it. Griffith, Pereira, Christison, the United States Dispensatory, Royle, Dunglison, Taylor, and Carson, are among the standard authors who use the nearly stereotyped phrase, "Thomson himself was tried for murder for killing a man with this article." This is a grave accusation; and, as it stands in this naked and unqualified form, it is a severe record for writers of such eminence to keep repeating for so many years after their victim is in his grave. If lobelia is a dangerous article, by no means let one jot of the evidence against it be concealed; but in the trial above alluded to, the death was proven to be in no way connected with the use of lobelia, and Dr. Thomson was declared to be an entirely innocent man. By repeating the charge against him, yet studiously and persistently omitting all mention of his acquittal, those eminent Allopathic authors show themselves so moved by malice as to be willing to brand an innocent man with the darkest criminality, and to fasten a heritage of disgrace upon his children, in order to vent their "malevolent envy" against him and his discovery.
The trial of Dr. Thomson alluded to, took place before the Supreme Court in Salem, Mass., in December, 1809. It was on a charge of murder, in that Dr. Thomson had administered lobelia to sundry persons, and especially to one Ezra Lovett, jr., in January of the same year, whereby death had been caused. The prosecuting complainant was an Allopathic physician by the name of French. During the previous year, this Dr. French had repeatedly threatened to take Dr. Thomson's life; and sought to entice the latter into his neighborhood with the determination, publicly avowed, of blowing out his brains. Dr. Thomson was finally compelled to appeal to the courts, and Dr. French was bound over in $200 to keep the peace. Pursuing Dr. Thomson with every species of persecution, but steadily failing in them all, French finally procured a warrant for his arrest on the charge of murder. Dr. Thomson's narrative of the proceedings is, in part, as follows:
"Just before night, Dr. French arrived with a sheriff, and ordered me to be delivered up by the constable to the sheriff. Dr. F. again vented his spleen upon me by the most savage abuse that language could express; saying that I was a murderer, and that I had murdered fifty and he could prove it; that I should be either hung or sent to the State Prison for life, and he would do all in his power to have me convicted. I was then put in irons by the sheriff, and conveyed to the jail in Newburyport, and confined in a dungeon with a man who had been convicted of an assault on a girl six years of age. I was not allowed a chair or a table; nothing but a miserable straw bunk on the floor, with one poor blanket which had never been washed. I was put into this prison on the 10th day of November, 1809. The weather was very cold. No fire, and not even the light of the sun or a candle; and, to complete the whole, the filth ran from the upper room into our cell, and was so offensive that I was almost stifled with the smell. I got no sleep that night, for I felt something crawling over me, which caused an itching; and my fellow-sufferer said it was lice. In. the morning, I was called on through the grate to take my miserable breakfast. It consisted of an old tin pot of musty coffee, without sweetening or milk, and was so bad as to be unwholesome; with a tin pan containing a hard piece of Indian bread, and the nape of a fish which was so hard I could not eat it. The weather was very cold, and I suffered from that cause; and likewise from the bad air in our miserable cell. Many of my friends came to see me, and some of them were permitted to come into the cell; but the air was so bad, and the smell so offensive, that they could not stay long. My friend, Dr. Shepard, came to see me, and was admitted into our dungeon. He staid a short time, but said it was so offensive he must leave me; that he would not stay a week for all Newburyport. There was nothing in the room to sit upon, higher than the thickness of our bed."
There was to be no regular session of this Court till the fall of 1810, so that the prisoner would have to lie in this miserable condition for a year–a period sufficient to have destroyed him. Through the efforts of some eminent jurists who interested themselves in his case, and who went from Salem to Boston fifteen times on this errand, Judge Parsons finally consented to hold a special session on December 10th, 1809. Judge Parsons with his own hand drew up the judicial account of this trial, which is published in vol. vi, Massachusetts Criminal Reports. The Judge, on the trial, showed the fullest sympathy with the prosecution, and none for the prisoner beyond what plain justice demanded. After giving an abbreviated account of Dr. Thomson's treatment of the deceased Lovett, and of the fact that the patient had several times been vomited by lobelia, the report proceeds:
"The Solicitor-General also stated that, before the deceased had applied to the prisoner, the latter had administered the like medicines with those given to the deceased, to several of his patients, who had died under his hands; and to prove this statement, he called several witnesses, of whom but one appeared. He, on the contrary, testified that he had been the prisoner's patient for an oppression at his stomach; that he took his emetic powders several times in three or four days, and was relieved from his complaint, which had not since returned; and there was no evidence in the case that the prisoner, in the course of his very novel practice, had experienced any fatal accident among his patients. As the Court were satisfied that the evidence produced on the part of the Commonwealth did not support the indictment, the prisoner was not put on his defense. The prisoner was acquitted."
It seems astonishing that an innocent man should be thus persecuted and abused, in the nineteenth century, merely because he had made an innovation upon an existent practice of medicine. Such treatment in prison, sounds more like the barbarisms of Russia in the middle ages, than like free and enlightened America. But the prosecution utterly failed. The testimony of Dr. French was a mass of venom; and his description, under oath, of the plant lobelia, was a tissue of misstatements. The only witness whom the Solicitor-General could obtain to prove his bold assertion of Dr. Thomson having killed several patients, testified to the rare value of his emetics on the witness's own person! The Court declared that there was "no evidence of any fatal accident among his patients." and dismissed the prisoner without even allowing him to enter upon his defense! Four Justices were on the Bench. A more complete acquittal, a more thorough rebuke of malicious persecution, could not be furnished; and law and society have no higher evidence of an accused man's unqualified innocence. In the face of such an acquittal, the author must be deaf to honor who can refer to that trial as proving the guilt of Dr. Thomson and the poisonousness of lobelia. The writer who uses such an argument against lobelia, shows himself possessed of enough malevolence to persecute a dead man's honest name, if in so doing he can hope to gain any thing to his own "professional pride." A lower form of baseness is scarcely known to the moral sense of the civilized world; and if honorable Allopathists wish to escape the odium that naturally attaches to any man who falsifies Court records in order to injure another, they must cease making this untrue reference to the trial of Dr. Thomson, and also discountenance those who do make it.
After the trial of Dr. Thomson, no way being left by which it seemed probable that lobelia could be put down in courts of justice as a poison, the Allopathic profession used their influence to get the State Legislatures to enact laws making it an offense to practice medicine without a diploma. As there were none but Allopathic colleges, this method was considered effectual for putting down this "new practice," and Massachusetts, Connecticut, Maine, Vermont, New York, Michigan, Georgia, Virginia, the Carolinas, and probably some other States, enacted such laws. In New York, the law forbade the prescribing, the selling, and even the giving away, of lobelia; and in all the States, the spirit of the American Constitution was violated in thus denying to the people all right to choose their own medical advisers, and to "new-school" physicians all power to collect pay for services performed under contract with those who employed them. The drift of these laws may be seen in the facts that, First. Fines to be imposed under them were to be divided between the informer, (always an Allopathic physician,) and the State Allopathic Society. Second. That no restriction was placed on the use of arsenic, antimony, blood-letting, prussic acid, strychnine, and similar powerful means of destruction currently used by Allopathists. The people in their majesty finally abrogated such tyrannical laws, and left Allopathy to stand as best she could without these monopolies; but the oppressing spirit that guided the greater number of that branch of the profession, was thoroughly illustrated in these enactments which they procured. It was in consequence of these laws that Dr. Thomson was at last driven to procure from Washington letters patent to protect himself in his practice.
While the laws above named were in operation, numerous indictments were found against reformatory physicians in various parts of the country. The prosecutors were invariably Allopathic physicians, and the greater portion of the witnesses were of the same class. There was no lack of evidence against lobelia—many Allopathic physicians of high standing unqualifiedly asserting, on oath, that ten, or eight, or even four grains of this article, were sufficient to cause death. An oath, especially when it is to affect the life of a fellow-being, is a solemn thing; but when those oaths came to the test-question of their correctness, they could not be substantiated. There was nothing to prove that any person had been destroyed by such doses of lobelia, or by doses of any size whatever, or that the bold witnesses had ever seen man or animal either killed or injured by this drug; but there was abundance of evidence, by physicians and patients, that these latter witnesses had given, and had themselves taken, from half an ounce even to four ounces of lobelia in the space of a few hours, and always to the improvement of their health. Thus the Allopathic testimony was proven in open court to be nothing but closet speculation, without a shadow of truth, and from the lips of men who had not used lobelia, and who in one instance solemnly swore that the herb marsh rosemary was lobelia! In no instance was any man convicted of doing harm by the use of this agent. I challenge any one for evidence that such a judgment was any where rendered by any court against this article; and though there was always enough Allopathic swearing against it, the character of that swearing was always as above indicated.
Yet it is currently stated that convictions have been had in England for causing death by lobelia. It seems anomalous that evidence of this kind has to be brought from so far, when the use of the agent originated in America, when so many thousands of physicians in our own country have used the article so long and in such enormous quantities, and when so many attempts at conviction here have failed. Such distant proof smacks of trickery. However, truth in England is as good as truth in America; and if lobelia is a poison there, it is a poison here. Let the evidence be looked into. One man is reported to have been condemned to three months' imprisonment for "killing a man with lobelia." The punishment looks remarkably small for so grave a crime–especially in England, whose courts have not unfrequently condemned a man to ten years of banishment for stealing a loaf of bread when starving, and one of whose local courts has just now (November, 1868) condemned a young girl to twenty-one days' confinement at hard labor for plucking a sprig of lavender from a shrub in a gentleman's garden! It is improbable that any such verdict was meted out for causing death by lobelia; and the actual fact simply is, that a man in London gave an emetic to a fellow-workman, and the workman died, and the man was sent to prison for daring to practice without a license. This was the ground of the conviction, and the poisonous or non-poisonous quality of lobelia was not pronounced on by the court, nor was the man's death charged to lobelia.
Again, it is asserted that Dr. Letheby, of London, made a chemical analysis of the stomachs of several persons for whom lobelia had been prescribed, and found in them a large quantity of this drug. This looks like very positive evidence; for Dr. Letheby is an eminent and learned man, and chemistry is a very definite science. But chemistry has no means of detecting lobelia by analysis; and not a single reagent is known which will give the least intimation of the presence of this article. Morphine, strychnine, nicotine, and other chemical products of plants, may be detected by chemical means lately discovered; but no such tests are yet known for lobelia. This single fact, which is indisputable, shows that Dr. Letheby could not, and never did, detect the presence of lobelia in the stomach by chemical analysis. But Dr. Letheby was an honest man, and one who would not degrade his science to bad purposes. He did make analyses of persons said to have been killed by lobelia; and it was clearly proven that lobelia had been prescribed for those persons a short time before their death. But it was also proven that an Allopathic physician prescribed lobelia to "try" it, and the druggist had no lobelia; but as the physicians had all been asserting that lobelia and tobacco were one and the same thing in action, the prescription was filled with tobacco instead of lobelia. This was what the patients took; and this was the "peculiar brown powder, with the smell of tobacco," that Dr. Letheby found in their stomachs. Judging only from the prescription, it would be fair to say that lobelia was found in those stomachs; but judging from the "whole truth," as required by law and common honesty, and the deaths were from tobacco. And this article was given to them because the doctors had falsely represented the action of lobelia, so as to make the druggists believe that tobacco could be substituted for it. The deaths thus really arose as a remote consequence of those malevolent misrepresentations; and so the juries found verdicts, neither condemning the druggist for making a substitution that accorded with the "regular" statements, nor convicting the doctor for directing the use of a deadly article. Had lobelia really caused death, the Allopathic physician should have been condemned; for he professed to know beforehand that the drug was of a deadly character.
Prof. Alfred S. Taylor, in his Medical Jurisprudence, a standard volume in Europe and America for the use of lawyers and judges in all questions at law, gravely asserts that lobelia is a poison; and he quotes the above trial of Dr. Thomson, and the above analyses of Dr. Letheby, as proof in the question. He carefully keeps back the results both of the trial and the analyses; and thus places himself before the world as one who would offer information to guide the courts, by presenting legal statements in a light known to the law to be perfectly false! And this same author presents as additional evidence of the poisonous character of lobelia, the statement that, in six instances, coroners' juries in London had found parties guilty of causing death by its use. This statement, from an English writer of such eminence, is quoted the world over as conclusive proof on this mooted question. Any man of good sense knows that the "conviction" of a coroner's jury is not a conviction at all. Their verdict merely holds an accused party for examination before a proper court; and he is not even held for trial, till the latter examination justifies it. Thus a coroner's jury has no power whatever to pronounce on the guilt or innocence of an accused party who is not so much as on trial before it. Its verdict against a man is not worth the paper it is written on, unless sustained by a subsequent trial before a proper tribunal. Of course, Dr. A. S. Taylor knew these facts. The persons "found guilty " by London coroners' juries evidently were not convicted by any court with powers to try them, or else Dr. Taylor would have recorded it. This his so-called "proof," therefore, stands condemned on its own face as a subterfuge to bolster up an untruth. It is humiliating to see a man of Dr. Taylor's learning resort to so weak a method of bringing disgrace upon a remedy, and dishonor upon all who use that remedy; but he has chosen his own course, and it is my duty to expose the sophistry of his statement, that all honorable-minded men may see, and seeing refuse to become parties to, his shuffling prevarication.
Allusion has been made to the assertion that lobelia acts like tobacco. This assertion has been examined so thoroughly in the first part of this volume, that a child may see there is no resemblance between them. It is also said that it does not always kill patients, because they usually vomit, it up; but that if it be not ejected, then it will certainly destroy. This also is an utter fallacy, as thousands of physicians, and hundreds of thousands of patients can certify. The system may be so filled with it as to relax every fiber, and the patient retain such large quantities for six, or twelve, or more hours, and pass out of this condition without purging or vomiting, and find his health improved by the act. And by similar testimony can it be proven that not only is a little harmless, but that enormous quantities may be given with impunity. I have myself many times used an ounce of the herb within a few hours, and had it all retained; have given half an ounce to a babe six months old, in two hours' time; have given a child of five years four ounces of the seeds inside of seven hours, and had it retained; and in so doing have broken up most alarming attacks of disease, and promptly restored health from spasmodic conditions that otherwise would have been fatal. Other physicians have done the same, and many of them have given even larger quantities than this. Within the last seventy-five years, it is probable that not less than five thousand active practitioners have used this article every day, in all forms and in all imaginable quantities; and today their united experience comes up with one loud answer to the effect that lobelia is an absolutely harmless agent. During the same space of time, probably a million of people have used it on themselves according to their own judgment; and these also raise their voices to declare that the article is without any narcotic or other harmful property. Irresponsible parties make wild statements which they can not prove; and Allopathic physicians still assert that the agent is a narcotic poison, though in all their lives they probably have not used as much of it as any one of the above five thousand physicians prescribes in a single day. To their own discredit do they make these assertions; for, as Prof. Paine says of the opposition to Peruvian bark, they make them "in the very face of its triumphant success;" and the testimony of the above masses who have employed it so long and so largely, sweeps into nothingness this unsupported opposition raised by Allopathists to gratify their "professional pride or malevolent envy."
Scores of Allopathic physicians of the first eminence have seen the wonderful powers of this remedy; and have openly adopted its use, given its discoverer the credit he deserves, and defended its powers and its innocency, and that without mixing it with opium and prussic acid, as is now done. Among these I have room only to name Prof. B. Waterhouse, of Harvard University; and Prof. W. Tully, of Yale College. Prof. Waterhouse resigned the position he had held in Harvard for over twenty years, and openly adopted the new practice–setting an example of honesty in conviction and conduct that would soon close all the old-school colleges if followed by others. Prof. Tully, at Yale, equally honored with Waterhouse, made no concealment of his convictions in this matter; but at once adopted the remedy, and taught its true qualities as he learned them from Dr. Thomson. As his name is everywhere respected, as one of the brightest stars that Allopathy has had in this country, I will close this defense of lobelia with some extracts from a letter he wrote to Dr. H. Lee, of Middletown, Conn., dated March 22d, 1838:
"DEAR SIR: It is true that I have stated, in my public instruction, that lobelia inflata is entirely destitute of any narcotic powers. I have now been in the habit of employing this article for twenty-seven years, and of witnessing its employment by others for the same length of time, and in large quantities, and for a long period, without the least trace of any narcotic effect. I have used the very best officinal tincture in the quantity of three fluid ounces in twenty-four hours, and for four and seven days in succession; and I have likewise given three large tablespoonfuls of it within half an hour, without the least indication of any narcotic operation. I have superintended experiments with it, made by young men, and always with the same results.* * The experiments here alluded to, as Prof. Tully afterward explained, consisted in giving enormous injections of it to dogs, cats, rabbits, and other small animals, none of which could be killed by the article. I have known four and five tobacco-pipes full of it smoked in immediate succession, and without any narcosis; and I have also known it given by enema, and with the same result. In addition to this, no species of the genus lobelia, nor of the order lobeliaceae, is known to possess a particle of narcotic power. Dr. Bigelow, of Boston, was the first person who ascribed narcotic powers to this agent; and this he first did in 1817, but not from his own observations. [This was eight years after the above acquittal of Dr. Thomson, within 75 miles of Boston.] After Dr. Bigelow first pronounced it narcotic, subsequent writers very speedily converted ‘something as black as a crow, into three black crows;' and Dr. Ansel U. Ives, of New York, at last pronounced lobelia inflata to be a ‘deadly narcotic,' and. that its action as an emetic ‘is secondary, or symptomatic of the primary impression upon the brain, like that caused by tobacco and other narcotic poisons.' But all this is mere stuff, and closet speculation, and does not contain a single truth. There is no probability that Dr. Ansel U. Ives ever used the article in his life. . . . I am confident (the old women's stories in the books to the contrary notwithstanding) that lobelia inflata is a valuable, a safe, and a sufficiently gentle article of medicine; and I think the time will come when it will be much better appreciated. WILLIAM TULLY."
Components: Lobelia herb contains a moderate portion of a volatile oil, which is readily dissipated by heat, and may mostly be driven off by water quite below the boiling point. The most effective diffusive power of the article seems to depend upon this oil; whence age somewhat decidedly impairs the herb, and boiling water materially injures it. The seeds contain a notable quantity of fixed oil, sufficient to saturate in a few days any soft paper in which they may be placed. This oil may be obtained by warm pressure, or more effectually by treatment with ether, as will be mentioned hereafter. An alkaline liquid called lobelina may also be separated from its associated lobelic acid, by treating the seeds in a suitable manner. Water extracts the greater portion of the properties of the herb; but acts only partially upon the seeds, with which it makes a rather milky infusion. Alcohol acts on both portions of the plant, and diluted alcohol acts upon them both quite efficiently. The fixed oil is soluble in absolute alcohol and sulphuric ether. Vinegar, or diluted acetic acid, acts largely upon both herb and seeds; and has the additional property, in common with other acids, of fixing the volatile oil so as to prevent its dissipation. It is probably on this account that the use of vinegar in preparations of lobelia, or an acid state of the stomach when the article is taken, so effectually prevents the diffusion of its relaxing influence, and limits its action quite locally. (§227.)
Properties and Uses: The herb and the seeds are of the same action, the seeds being twice the strength of the herb. The herb is usually spoken of, unless the seeds are especially mentioned. It is a pure relaxant, possessing only the faintest moiety of stimulating property, and this of a transient character, expending itself upon the fauces, and the glands and mucous membrane of the mouth and respiratory organs. The quality for which it is so greatly valued, is its peculiar influence in relaxing the entire circuit of the organs and tissues–making prominent and diffusive impressions upon and through the nervous structures, but proving itself capable of reaching every portion of the body under the directing influence of the vital force. (§138, 139.)
When chewed, or taken in any liquid preparation, it first causes a peculiar and somewhat acrid (but never excoriating) feeling about the fauces. This is soon followed by an increased flow of saliva and mucus in the mouth; and this increase of the salivary secretion is always marked in the use of this agent, and renders it appropriate to the dry tongue and throat incident to all forms of fever. After being swallowed, it induces a sense of nausea; and the increase of mucous secretion is manifested through the whole length of the oesophagus. By the repetition of small doses at intervals of thirty or fifteen minutes, its relaxing impression will soon begin to be distributed through the body; first upon the capillaries and nerve peripheries, then upon the general circulation, and finally throughout the muscular and glandular systems. As some of the most valued benefits of the agent are derived from employing it in this manner, without either seeking or obtaining its emetic action, its advantages upon these several classes of structures may be studied separately.
The circulation is materially equalized by its use, and the blood-vessels relieved from a condition of tension, whether the case be one of inflammation or fever. By relaxing the circulatory apparatus, it favors a full outward flow of blood, with diaphoresis; secures greater fullness and softness of the pulse, with a reduced excitability of the heart; and from the universality of this influence, expedites the reestablishment of the secretions of the skin, liver, and kidneys. Such extensive impressions fit it for the treatment of phrenitis, meningitis, pneumonia, pleurisy, hepatitis, peritonitis, and nephritis, and to inflammation of the periosteum–whether on the long bones, alveolar processes, about the ear, or other places. In some of these cases, as of pneumonia and pleurisy, this agent alone (especially in the form of tincture) is many times sufficient to cure acute cases, providing they have not yet passed into the stage of actual congestion–as congestion requires very little relaxation, and that always associated with an excess of stimulation. This action also qualifies it for almost universal use in synochial, catarrhal, bilious, rheumatic, typhoid, and other forms of fever. Its use in fever is valuable beyond any other remedy that has ever been introduced to the notice of the profession, and that without any reference to its emetic action; for it secures that sanguineous distribution, cardiac relief, and secernent activity which are so positively demanded in all such cases, and this in a manner at once powerful and harmless. The article is rarely used alone in such connections, but usually with such diffusive relaxants and stimulants as the case may require; hence is generally made into infusion with an excess of such agents as asclepias, zingiber, polemonium, and others of this class. If the febrile action is of the congestive class, as a low typhus, a moderate quantity only of lobelia is required, and more and stronger stimulants are necessary. By suiting the amount of lobelia to the tension and force of the arterial action, it can be applied to the widest possible range in febrile action; and will manifest a curative power that of itself is sufficient to rank this agent as one of the most truly valuable ever offered to the medical profession.
The nervous system derives great benefit from it, as it is one of the most reliable articles to relieve all forms of suffering arising from tension and excitement of the tissues. Thus as a local application in external inflammation, over the seat of an abscess or a periostitis, on acute erysipelas or ophthalmia, and all other cases of the kind, it is of great efficacy; and internally in the suffering of acute rheumatism, or pleurisy, or periostitis, or meningitis, or neuralgia, it can be used to great advantage. In like manner, it is probably unsurpassed for securing relief from the nervous restlessness of acute hysteria, typhoid fever, delirium tremens, etc. As it acts upon the circulation simultaneously with its impressions upon the nerves, a large portion of the relief obtained in some of these cases is due to the manner in which it hastens the equalization of the blood; and thus it is of a double advantage to the system. Its action being diffusive, is rather transient, whence the article needs repetition at moderate intervals, yet not so frequently as in fever. When pain arises from approaching congestion, lobelia alone is not sufficient, but needs to be combined with diffusive stimulants; while in the suffering of gangrene, it is not applicable at all. (§238.)
Upon the muscular and fibrous tissues it expends its influence with a very direct and peculiar force. The nausea induced by it at the stomach, is the first manifestation of this, and the enlarging caliber of the pulse is from a similar influence upon the fibers of the blood-vessels. It is by this combined action upon both the nerves and muscles of the stomach, that small doses of weak lobelia infusion allay irritation of the stomach, and arrest spasmodic and even sympathetic vomiting; and so long as these doses can be regulated so as to make a nearly continuous impression, without any distinct intermission in which a contracting oscillation may occur, all efforts at emesis will prove ineffectual. (§210, 212.) By a persistent repetition of moderate quantities till the contractile efforts of the stomach are allayed, and then by the use of larger quantities either by drink or as injection, or both, (or more considerable quantities may be used at the outset, if the stomach is not peculiarly susceptible,) there is probably no fibrous structure of the frame but may be reached by this agent. And though it is a remedy chiefly used for acute cases, it may be employed to distinct advantage, in combination with more permanent agents, for chronic maladies of the same structures. The relief obtained from the use of lobelia in meningitis, pleurisy, peritoneal inflammation, and acute rheumatism, is probably due as much to its relaxing power over serous tissues as to its soothing impression upon the nerves. Its virtues are exhibited to the highest advantage in spasmodic and true membranous croups, hooping-cough, spasmodic asthma, (but not the humid asthma, nor that form of difficult breathing accompanying heart disease,) spasmodic strangury, subsultus tendinum, spasmodic occlusion of the gall-ducts, (as in the paroxysms of suffering from the passage of gall stones,) strangulated hernia, etc. So prompt and positive is its action in these several difficulties, that it may safely be set down as an absolute and reliable specific for them, so far as the excessive muscular contractility is concerned. In rigidity of the os tincae during labor, small doses at short intervals will secure the relaxation of those fibers in the most prompt and thorough manner; and this peculiar action of the agent, under the directing influence of the vital force, (§138, 139,) enables it to overcome a grave obstruction which has always caused the profession much anxiety, and makes this remedy one of rare value, even if it did not possess another useful property. The same remarks will apply to hour-glass contractions of the uterus; and to those ineffectual forms of labor in which a portion of the uterine fibers are rigid; under all which circumstances small portions of lobelia infusion, at intervals of ten or fifteen minutes, will presently relax the rigid fibers without at all interfering with the action of those which are contracting properly–results which the accoucheur many times desires with the greatest anxiety, and for the lack of which he too often resorts to his destructive instruments, but which are effected by lobelia in the most complete manner. At the same time it secures a free lubrication of the passages, and a more equable action of the nervous system. Yet lobelia is not a distinct parturient; and though its efficacy in expediting labor under the above peculiar circumstances is unsurpassed, it at no time gives vigor to uterine contractions, nor improves the force of weak and ineffectual pains. On the contrary, its persistent use will gradually relax the entire uterus, and finally all contractile efforts will cease till the action of the lobelia has passed by; and this may readily ensue in cases where the uterine and vaginal structures are already flaccid, or may be effected where the parts are somewhat unyielding and the pains so active as to be exhaustive.
The extent to which lobelia will relax the muscular tissues, may be inferred from the last paragraph. By its frequent repetition in full quantities, even if emesis should ensue for a few doses, it will eventually relax all the muscular structures, so that the patient will be unable to move a limb–not so much as to speak or to lift an eyelid. This is the condition which is currently described as the " alarm," from the fact that most Allopathic physicians become hugely frightened when they see a patient in this condition; and are apt to declare the patient about to die. To one ignorant of the action of lobelia, and unskilled in distinguishing the signs of disease, the state thus induced might indeed be pronounced "alarming;" but the experienced practitioner, and he who knows the difference between the physiology of health and disease, will feel no perturbation under the circumstances. The pulse is soft, slow, and steady; the breathing as even and as gentle as a sleeping babe's; and the secretions of the skin, and of all the emunctories, are increased largely, yet in a perfectly quiet manner. The distinctions between this state and that of narcotism were fully made in the department of Therapeutics. (§95, et seq.) It is a state often for a short period preceded by restlessness, and sighing respiration; but these are owing merely to some portions of the frame being more relaxed than others, and they cease so soon as all parts become relaxed alike. It is a condition in which every obstruction to the freest vital action of the blood, nerves, and secreting organs, seems completely broken up; and one from which the patient rallies in from one to three hours, or from which he may be rallied sooner by composition or other stimulants, enjoying a wonderful sense of relief from all previous weight of disease and morbific accumulations. If resorted to at the earlier stages of almost any form of fever, it often enables the practitioner to cast out the offending impurities at once, and to cut short the most unpromising attacks in a few hours. Its power in this respect is unequaled, and wholly unknown to those who have never employed the agent thus; and so rapid and effectual has been its work in this direction, that patients have rallied so quickly from alarming attacks in the incipient stages, as not unfrequently to think that they were scarcely threatened with illness. It was this method of using lobelia that gave Dr. Thomson and his coadjutors such almost miraculous success in febrile difficulties; and at the same time spread the impression that lobelia was a deadly narcotic, of similar action with tobacco. It is a procedure best suited to difficulties of the synochial grades, as to bilious, bilious remitting, and rheumatic fever, inflammation of the liver and periosteum, and similar cases where the arterial action is full and strong. But it is not adapted to asthenic forms of fever, and to low and semi-putrescent conditions, such as diphtheria, malignant scarlatina, typhus and typhoid fever, (particularly after the first few days,) nor to puerperal or pleuritic fever at a stage when effusion is liable to take place. Patients whose limbs are fixedly drawn into contorted positions by chronic rheumatism, can usually have those limbs straightened in a remarkable manner when relaxed into this condition of "alarm;" and that replacement of contorted muscles is quite sure to remain, in part, after the relaxation has passed off; and a repetition of this procedure, with suitable intermediate treatment, will many times effect complete restoration.
This relaxing power over muscular structures is of great advantage not merely in the spasmodic affections above alluded to, but in spasmodic and convulsive troubles of the severest grades. Thus, in strangulated hernia, and in fits of hysteria and epilepsy, it is powerful in cutting short the clonic contractions; and in puerperal convulsions it presents to the profession a curative agent of the most unfailing character against one of the most alarming difficulties in the nosology. The latter remark applies with equal correctness to the influence of this remedy over trismus, tetanus, and all forms of tonic spasms. This class of maladies, and also puerperal convulsions, are among the most intractable to which physicians are called; and are commonly looked upon as irremediable, except as nature may voluntarily cease the abnormal contractions from utter exhaustion. But in lobelia inflata is found a cure that probably has never failed in any case where it has been tried properly and faithfully; and the perfect relief it has afforded in numbers of the severest cases, attests its reliable power under the most unpromising circumstances. Failure in its use may result from two causes:
- 1st. In not giving sufficient quantities, which in such maladies require to be enormous.
- 2d. In not associating with it caulophyllum or scutellaria or similar nervine tonics, in puerperal cases; or xanthoxylum or capsicum to sustain the circulation, in tetanic cases. (§245, 246.)
If due care is thus taken to maintain a proper action on the nerves and blood-vessels, lobelia may be depended on to accomplish the relaxation of the muscular structures; and by making the doses commensurate with the severity of the case, experience warrants the belief that this remedy will prove as nearly unfailing in such maladies, as it is possible for any remedy to prove in any case. In the contraction of the muscles about a joint, incident to dislocation, and which often presents such an almost insurmountable obstruction to the return of the bone, a due use of lobelia (by drink and enema) to the point of relaxation will unfailingly relieve the tension and allow an easy reduction of the parts. And in that peculiar and terrific malady, hydrophobia, its bountiful use has been attended with the most gratifying results. Possibly the paroxysms of this malady may never be overcome so effectually but that the virus remaining latent in the system will continue to manifest itself at intervals; but the evidence is unquestionable that the free use of lobelia–first to secure vomiting, and then profound relaxation–has repeatedly, and perhaps in every instance where used, saved the lives of patients bitten by rabid animals; and it will prove effectual in cutting short any light paroxysms of the malady that may occur subsequently. The same remarks apply with equal force to the treatment of other poisoned wounds, as the bites of serpents, enraged rats, etc. in which cases lobelia emetics carried to a point of very considerable relaxation, and followed by diffusive and depurating stimulants, will prove most powerful means for procuring the ejectment of the virus.
The action and the value of lobelia in procuring emesis, have been described fully in the department of Therapeutics, and need no repetition here. Many suppose that the agent is good only to procure vomiting; but while it is unlike, and immensely superior to, all other agents for this purpose; and while emesis secured by lobelia, with a suitable use of stimulants and astringents, is a measure of vast power under such a variety of circumstances; the value of this agent in this connection is only one of its useful employments. Indeed its use in this connection is perhaps scarcely as important as in some of the above cases, where it may be given in free quantities, and in such a manner as not to induce any vomiting whatever; though in many of these it is often advisable first to secure vomiting, and then to continue the agent so as to secure suitable relaxation; but this course is one which is left to the judgment of the practitioner.
Allusion has been made to the influence of lobelia upon the secretions. This is somewhat peculiar, and also very extensive. During complete relaxation, the flow of perspiration is abundant; and a free discharge of urine and faeces, as well as of bile, is sure to follow. The same takes place in using lobelia for procuring emesis–a good sweat being a direct accompaniment of this act, and the evacuation of the bowels and bladder almost surely ensuing. Not that the article is in any sense cathartic; but its relaxing power over the liver and gall-ducts rarely fails to secure the excretion of bile; and its influence upon mucous membranes induces a free lubrication of the alvine canal; whence the bowels are soon naturally evacuated, as a common rule, yet never in the manner of a physic. (§172.) In the same manner it secures a discharge of urine; it is a pure and positive relaxing expectorant; and thus also the menstrual and lochial flows will usually be promoted with great promptness by a lobelia emetic, if these discharges have recently been obstructed. By the extensive distribution of blood that an emetic induces, this measure is also peculiarly powerful in arresting hemorrhages of the most violent character, whether from the lungs, uterus, or other organ. It is true that a considerable portion of the good effects is, in this as in all the other cases, due to the agents used simultaneously with the lobelia. This is a fact to be remembered at all times in using this article; whence it is combined with such agents as asclepias and zingiber in treating fever; with caulophyllum and capsicum in treating convulsions; and with the astringing and stimulating Composition Powder in managing hemorrhages. But while lobelia is thus variously combined to meet the requirements of different conditions, it is none the less true that its relaxing power expedites the diffusion and intensity of any agent with which it may be associated. (§260.) This fact is made available in employing a limited quantity of lobelia in conjunction with remedies suitable for dropsy, and chronic abscess, and pleuritic effusions, where its relaxing influence relieves local rigidity and facilitates absorption; or with other agents for chronic gastritis, chronic hepatic irritation, chronic irritability of the kidneys or uterus, etc. In such cases, the amount of lobelia used needs to be quite small indeed; yet its effect on all the secretions is then as perceptible as is its influence in procuring salivary discharges when the tongue is dry and furred. As an outward application, lobelia is joined with demulcents for external inflammation in all positions boils, acute swellings of muscles and other parts, incipient abscesses, sprains, bruises followed by acute inflammation, etc. In deep-seated inflammation, as in various forms of periostitis, during the earlier stages of hip disease or white swelling, and on similar dense structures, the amount of lobelia needs to be very great; and the seeds are then usually preferred to the herb. In acute ophthalmia, its infusion may be used in the eye three or more times a day, to great advantage; and nightly poultices used over the lids, though these will make the lids puffy after the acute inflammation has subsided. In chronic ophthalmia, when the circulation in the blood-vessels becomes sluggish, a moderate quantity of lobelia will prevent gumminess of the secretions, while such agents as hydrastis secure tone. It is not a suitable agent to use on carbuncles or other sores of a gangrenous cast, and it usually promotes the absorption of virus from a bubo to the disadvantage of the patient; though small quantities may be combined to advantage with tonics and stimulants to preserve a free discharge in chancres and other semi- indolent sores. It is useful externally in irritable forms of tetter and eczema, the poison of rhus toxicodendron, etc.
I am aware that this account of lobelia awards to it most extensive and remarkable powers; but not one jot more than is verified to the fullest degree by the united experience of the thousands of physicians who have used it so largely during the last seventy-five years. No one article of the Materia Medica influences such a vast range of structures, nor influences them so promptly and powerfully; hence no other remedy can be used in such a variety of maladies. It is not pretended, however, that it is the only agent to be used in the above-named forms of disease; for such an idea would not accord with the facts, nor be in keeping with the true teachings of Therapeutics on the subject of Specifics. (§155,165.) So far as its own individual action is concerned, it is indeed a specific relaxant; and because some grade of relaxation is needed in such a large number of affections, and because the laws of vitality (§138) and the principles of combining remedies (§263) admit of its influence being directed upon any desired part, lobelia becomes one of the most universally employed of all relaxing agents. But, like any other agent, it may be wholly misapplied; and if the practitioner does not fix his mind clearly upon its true character, its vast power may lead him to employ it indiscriminately, and thus draw him into its use for conditions to which it is not at all suitable. These conditions may, in brief, be brought, under the simple expression of, Maladies in which relaxation is already present. These would include all cases of soft and sluggish pulse, greatly hurried but prostrated (or intermitting) pulse, loss of nervous sensibility, loss of consciousness, paralysis, and mortification or gangrene. As the structures are then in a too flaccid state, it is plain that relaxation is not required, (§55;) and as certain forms and stages of asthma, croup, pneumonia, pleurisy, cough, and all the maladies named above, may present a state of relaxation, or of very moderate irritability with great depression, it at once follows that the use of lobelia must be greatly diminished, or even discontinued –while the use of stimulants is proportionately increased–under the new circumstances. An instance of this kind is found in typhoid fever; for here the arterial and nervous centers may present such a strong tendency to relaxation, that any material amount of this agent (especially if given by the stomach) will induce unneeded relaxation of the heart, with sighing respiration and intermitting pulse. Here a great error might easily be committed by employing this agent in considerable quantities; and the more so if the malady have continued for several days, and a tendency to putrescence is increasing. And yet a certain wiriness of the pulse, and continued subsultus tendinum, may call for some relaxation; and continued dryness of the mouth, with stupor or delirium, may indicate the need of emesis. In such conditions, lobelia may be given in suitable quantities by enema, even to the procurement of efficient vomiting, while the necessary stimulants are given by the stomach; and thus the nerves be relieved, and obstructions of the portal circle be overcome, and the blood be distributed toward the surface, while the tone of the heart and large arteries is maintained or increased. (§143.) In like manner, it is improper to use large quantities of this article in dropsy, peritoneal effusion, congestive chill, delirium tremens, or any form of congestion with distinct prostration; and in putrescent maladies, it is improper to induce relaxation by its use, though such cases are often very positively arrested by a prompt emetic if of the truly stimulating grade.
Dose: The quantity of lobelia given at a time depends materially upon the object sought. In the cases named in the last paragraph, where a very little relaxation is to be associated with a large excess of stimulation, two grains an hour would be sufficient; and a smaller quantity than this would answer the purpose, if the agent were to be continued for any length of time. In febrile cases, and for expectorant purposes, where a medium relaxing influence is sought, the strength of from two to five grains (according to the nausea induced) may be given in infusion within an hour; though rheumatic fever, periostitis, hepatitis, and other cases in which the tension of the structures is considerable, will require larger quantities than this. These are called "broken doses," from their being portions of the representative emetic dose of forty or sixty grains. If used by enema, five or ten grains at intervals of six or four hours, are usually sufficient; though such a quantity may be repeated every two hours, or even oftener, if circumstances require it; but much larger quantities are often needed. Enemas should usually consist of the powder in a suitable quantity of demulcent; and is a form especially advisable in spasmodic cases, rheumatic contractions, typhoid maladies, and meningitis or similar affections of the brain. But in these and all other cases, the quantities may be increased to suit the emergencies; croup and puerperal or other convulsions require very great quantities, in company with strong stimulants; and if profound relaxation is sought, moderate doses should be continued for a time at quite short intervals, and then the size of the dose greatly increased–enema and infusion often being employed at the same time. The seeds have at least twice the strength of the herb. On the other hand, if an irritable stomach is to be quieted, the strength of one-fourth of a grain, by infusion, with a little demulcent, is usually enough; and if the os tincae is to be relaxed, one grain every five minutes is generally sufficient. When a very large dose is given in some cases, and especially so if by injection, and without previous relaxation, one portion of the system may be relaxed, and some interfering obstruction prevent the relaxing impression from reaching all the structures quickly. This causes a loss of balance between the two portions of the frame; and while this continues, the patient may manifest symptoms of a peculiar and somewhat violent character–such as severe crampings in the stomach and bowels, intense pain in the head or liver, or ungovernable restlessness. Sometimes the patient will writhe about as if in spasms; at others, he will throw himself out of and under the bed, or otherwise run about as if a maniac; and in a few cases, the most agonizing priapism has occurred. These symptoms are dependent entirely upon a lack of equalization of the relaxing impression so suddenly made, and evidence the extent to which obstructions prevail somewhere. So soon as these obstructions yield, the agitations cease, and no anxiety need be felt at such symptoms, as they are not dangerous.
I. Infusion. The strength of an infusion should depend entirely upon the objects sought. A full average strength would be a drachm to half a pint of water; but in compound infusions for febrile cases, it is seldom that more than from ten to twenty grains are used in a pint of the preparation, and this given in doses of from two. to four fluid drachms every thirty or forty minutes. For emetic purposes, or to secure full relaxation in rheumatic or convulsive difficulties, or in dislocations, a drachm to four fluid ounces is usually preferred. In making any infusion, boiling water should not be used, as such a degree of heat readily impairs this agent. The infusion is by all means the most suitable form of preparation for emetic purposes. It is also the best form for enemas, when the article is not given in powder.
II. Extract. A solid extract of this agent may be prepared by bruising the green herb, macerating it for a few hours with a small quantity of diluted alcohol, and then subjecting it to very strong pressure. Or the juice may first be pressed out, and the herb then macerated with diluted alcohol and subjected to a second pressure. To each quart of the fluid product, add two fluid ounces of good cider vinegar, by which the volatile qualities will be retained, and without which the product will be nearly inert. Evaporation must then be hastened by putting the juice in quite shallow vessels, and exposing it to the sun. Unless evaporated to the consistence of molasses in a short time, it will become sour; yet the heat of an oven, or even the rays of a too hot sun, will materially weaken the product. It does not reach a solid form, but remains slightly plastic; and if the seeds of the plant used have been advanced well toward ripeness, the extract will be of a somewhat oily feel. It is a powerful article, when properly prepared; but very little that is really good ever comes on the market, though Dr. H. H. Hill, of Cincinnati, often has an excellent article. It may be given in pill form, in doses of from one to three grains, at intervals of four hours or less. Like other substances in pillular form, it exerts its influence slowly; and is a good article to use when a moderate and continuous relaxing influence is needed in febrile and acute rheumatic cases–suitable diaphoretic stimulants being given in infusion in the usual manner. By enlarging the dose of lobelia extract, and making use of rather stimulating drinks, light emesis will be secured at intervals of a few hours, without much complaint on the part of the patient; and this is an admirable and effective method of securing the ejectment of morbific materials and the breaking up of ordinary fever. I have sometimes used this extract as a plaster over seats of acute suffering, as irritation of the spine, chronic synovitis, incipient necrosis, etc., with excellent results. In one case of incipient morbus coxarius–where the parts contiguous to the joint were much swollen, hot and tender, and the suffering so acute that for two weeks the patient had had no refreshing sleep, despite the large quantities of morphine that had been used under other physicians–a large plaster of lobelia extract relieved the suffering and secured sleep in less than ten hours, and the progress of the patient was remarkably excellent. [See P.-M. Recorder for 1862.)
III. Fluid Extract. Crush one pound of lobelia herb well, and macerate it for twenty-four hours with a pint and a half of diluted alcohol and one fluid ounce of acetic acid; transfer to an earthen percolator, add another pint and a half of diluted, alcohol, and then continue the process with water till three pints of tincture have passed. This is now to be evaporated on a water bath till ten fluid ounces remain; to this six ounces of 90 percent alcohol are to be added, to dissolve all the extractive matter possible, when the whole is to be filtered through paper. This formula was proposed by Dr. Wm. Procter, of Philadelphia, and is the one now usually employed. The acetic acid effectually prevents the dissipation of the virtues of the plant during the evaporating process. It is mostly used as an expectorant and nauseant, for which purposes five drops are an average dose. About thirty drops are usually efficient as an emetic, though the small portion of acetic acid does not make it very desirable for emetic purposes.
IV. Tincture. Four ounces of crushed lobelia herb, including the seeds in the capsules, are to be tinctured for ten days in the usual way in a quart of diluted alcohol. Or the process of percolation may be used. The tincture is a very diffusive preparation, most usable in acute pleurisy, pneumonia, rheumatism, and spasmodic croup; but not as available as the infusion for membranous croup, fevers, peritonitis, hepatitis, or emetic purposes. Though frequently employed for emesis, its diffusion toward the surface is so very rapid that the result is not always satisfactory–especially as it seldom so affects the internal secernent organs as to secure a good discharge of bile or urine. By some physicians, it is considered superior to the infusion for all classes of clonic spasms, including asthma and hooping-cough. It is more acridly exciting to the fauces than any other form of the article; and is also very nauseating, but not suitably quieting to the nervous system.
V. Acetous Tincture. Lobelia seeds, well ground, two ounces; distilled vinegar, (or twenty percent acetic acid,) one pint; macerate for a week, express the liquid, filter, and add an ounce of diluted alcohol. As acids curtail the diffusiveness of lobelia very much, the action of this preparation is mainly local. It acts powerfully on the respiratory organs as a relaxant and stimulant, promoting expectoration rapidly, loosening the exudation of membranous croup, and relaxing the spasms of hooping-cough, spasmodic croup, and asthma. It is mostly employed for these purposes in doses of from five to ten drops in flaxseed tea, or other demulcent, every hour or oftener. In doses of from one to two fluid drachms, in a demulcent, every fifteen minutes, it proves quickly emetic in membranous croup; but no acetous preparation can secure that form of vomiting which induces that grand outward flow of blood and opening of the emunctories which are such important adjunctive results of an ordinary lobelia emetic. It is not, therefore, a suitable form to employ in common emetics, though it may serve a good enough purpose in the cases where a very prompt and wholly local action is required. It seems to me probable that the use of this tincture, in conjunction with a tea of bayberry, might prove a good method of procuring vomiting in cases of narcotic poisoning. Diluted with its own volume, or more, of rose water, it forms a good wash for ringworm, dry tetter, eczema, and similar scaly affections of the skin. At present, it is seldom employed internally, the acetous sirup superseding it.
VI. Acetous Sirup. In one pint of the above acetous tincture, dissolve two pounds of white sugar at a gentle heat, carefully removing the scum which arises. It is far more pleasant than the acetous tincture, and equally efficient; and is employed in the same cases as those for which the latter preparation is prescribed. I especially value it for membranous croup and dry asthma, for both which it is a stimulating expectorant of great power. Dose, half a teaspoonful or more, repeated every half hour or hour in acute cases.
VII. Oxymel, Honey of Lobelia. Tincture bruised lobelia herb (the green herb being preferable) in enough good cider vinegar to cover it thoroughly; express after a week; and mix with it clarified honey at the rate of three pounds to a quart of the tincture. Evaporate on a water bath to the consistence of thin molasses. This is a very serviceable preparation for dry and irritable coughs, humoral accumulations in the lungs, and similar difficulties. It is much less stimulating, and more soothingly expectorant, than either of the acetous preparations. Dose, ten to thirty drops at such intervals as suit the case in hand. It requires to be kept in a cool place. The Balsam of Honey, named below, is pleasanter than oxymel.
VIII. Oil. This oil is best obtained by treating half a pint pulverized seed with ten fluid ounces of sulphuric ether for a week; then transferring to a close percolator, and treating with ether till twenty-four fluid ounces have passed. The product is then to be evaporated spontaneously. This is a pale-yellow, transparent, and slightly viscid fluid. By many it is claimed to be a remarkably concentrated representative of the seeds, and five drops are spoken of as an emetic dose. For myself, my experience does not warrant the opinion that this oil is any thing better than the fixed oil which may be obtained by warm pressure, except that a little odor and taste of the ether cling to it persistently. I have repeatedly given a teaspoonful without any more effect than would be obtained from a teaspoonful of an ordinary infusion. This may be owing to no reliable specimen having yet fallen into my hands; and I would be pleased to hear from the profession on the subject.
IX. Lozenges. A pleasant lozenge may be formed by adding of strong acetous tincture, one pint, to four pounds of white sugar, and drying into a candy form at a quick heat. They are an efficient relaxing expectorant for irritable coughs.
X. Compound Tincture of Lobelia and Capsicum, Antispasmodic Tincture, Thomson's Third Preparation. Lobelia seeds and capsicum, each half an ounce; cypripedium, two drachms. Tincture with eight ounces of the Compound Tincture of Myrrh. This is the form in which Dr. S. Thomson made the compound which has become famous as the "Third Preparation of Lobelia." It is probably the most powerful stimulating and relaxing compound ever devised, making its impressions with wonderful force, and extending through the system, as Dr. Thomson well remarks, "like electricity." It will not secure the relaxation of lobelia; but powerfully arouses the stomach, the circulation, and the nervous system. It may be used in doses of a teaspoonful, or much more, in water or some demulcent infusion, when vomiting is required under circumstances of depression–as in narcotic poisoning, apoplexy from over-eating, membranous croup when lobelia alone will make no impression, etc. It is to be given at short intervals, so as to obtain very prompt action. In sudden depression of the pulse, all forms of collapse, and shock of injury, it is unequaled as a stimulant; and may be given in doses ranging from a few drops to one or two teaspoonsful, every five or ten minutes, till reaction is obtained. In drowning, it powerfully excites the fauces and ganglionic system; and half a tea spoonful or more poured into the mouth at short intervals, and made to run down the throat, may arouse a gasping effort at breathing which may save the patient. It is a most efficient antispasmodic, (§246,) and may be used in severe cases of lockjaw, hysteria, epilepsy, puerperal convulsions, and similar cases. In the latter maladies, it may be given by the stomach or as enema. For antispasmodic purposes, it is usually more intensely stimulating than even prostrated cases require; whence a variety of formulas has been proposed under the general term of Antispasmodic Drops. Dr. Wilkinson employed equal parts of the saturated tinctures of lobelia seeds, cypripedium, and capsicum. My own formula for these purposes, is the following: Lobelia seeds, two ounces; caulophyllum, cypripedium, and anise seeds, each one ounce; capsicum, half an ounce. Macerate with a sufficient quantity of 60 percent alcohol; transfer to a percolator, and treat with the same alcohol till a quart has passed.
XI. Balsam of Honey. Under this title, Dr. Wilkinson offered the following compound in his Botanic Medicine: Tincture of lobelia, one pint; essence of anise and of sassafras, each four ounces; clarified honey, twelve ounces. So much alcohol is objectionable; and I have found it preferable to add fifteen drops each of oils of anise and sassafras to the tincture, by trituration with a suitable quantity of sugar, and then add the honey. It is a very efficient expectorant and antispasmodic in recent coughs, hooping-cough, dryness of the air passages, etc. Dose from ten drops to a teaspoonful.
XII. Compound Pills. Lobelia seeds, cypripedium, and asarum, each one ounce; softened extract of boneset, a sufficient quantity. Make into four-grain pills. One or two of these may be used at proper intervals as a mild nauseant and expectorant; but are of much value in ordinary nervousness, mild hysteria and neuralgia, nervous headache, and ordinary sleeplessness. I have also employed from two to four of them during the night, for chordee, and with success. Two every four hours will usually relieve the wiry pulse and nervous tension which often remain after an attack of inflammatory rheumatism.
XIII. Stomach Pill. Lobelia seeds, three ounces; apocynum, hydrastis and capsicum, each one ounce. Form into pills with a sufficient quantity of slightly softened extract of taraxacum. This is a good preparation in chronic atony of the stomach, with dryness or "slimyness" of the mouth and bowels, and in cases of dropsy and atonic forms of digestion. One may be used after each meal; or at shorter intervals if desired. They promote evacuations in atonic and semi-paralyzed forms of costiveness.
XIV. Suppositories. Lobelia seeds may be incorporated with simple cerate, and the mass stiffened with a suitable quantity of pulverized gum Arabic, and made into small conical suppositories. Each suppository should contain three grains of these seeds; or they may be made so as to contain, each, two grains of lobelia seeds and three grains of powdered cypripedium. By moistening the suppository for a few moments in lukewarm water, it may be inserted into the bowel without trouble. I have used them for several years to the greatest advantage for all acute pains in the pelvic region and lower bowels, and especially for restlessness, acute or chronic ovaritis, sciatica, neuralgia and rheumatism of the womb, and similar forms of suffering. Their action is slow, but very persistent; and the relief they afford is sometimes remarkable. One may be introduced every twenty-four, twelve, or six hours, according to necessity; and they enjoy a great advantage over injections in being able to exert a steady influence for so long a time.
Lobelia also enters into a great variety of other preparations, the tincture being often combined with stimulants and the essential oils in liniments; and the seeds used to make relaxing ointments with lard or other unguent. A good relaxing embrocation may be formed by using a pint of a saturated tincture of lobelia seeds, (on 90 percent alcohol,) two ounces essence of wormwood, and enough common hard soap (about two ounces) to form it into an opodeldoc. For expectorant uses, a few drops of tincture of tolu is excellent to disguise its taste. The mints, and the seeds of burdock, often moderate its nauseant impressions.
The Physiomedical Dispensatory, 1869, was written by William Cook, M.D.
It was scanned by Paul Bergner at http://medherb.com