By J. W. PRUITT, M. D., Russellville, Ark.
So much has been written upon this subject in the last fifteen years that we fear what we shall have to offer will seem to be little better than mere repetition. Doubt is the foundation of all improvement, and may be taken as prima facie evidence of error, imperfection, or that something better may yet be discovered than what is already known. Medicine is far from being and perhaps never will be a perfect science, but this does not prevent investigation and the exercise of those analytical powers of mind that peculiarly belong to the Caucasian race. (Aaargh—MM) The why and wherefore in every problem of science, government, theology, etc., has always engaged the attention of the most profound savants of every age. Without innovation mankind would not progress—everything would remain crystallised.
The introduction of the numerous new remedies in the last twenty years marks an era in medicine of no little importance. The workers in this field have presented us with a mass of material that requires careful sifting in order to ascertain what it contains of utility. Much time and patient thought and careful observation are necessary before we can learn the real value of each agent. This will appear when we reflect that physicians are not yet agreed about the properties of some of the old remedies. Many to whom the credit of introducing new agents belongs, speak of their curative powers with great enthusiasm, which the observation of others does not warrant. This may be owing to the employment of a spurious or inert article or giving it under wrong conditions by the latter, or a run of favorable cases with the former. At any rate we think prudence, caution, close observation, coupled with a wise conservatism, are the safest guides in arriving at the real truth.
We will now proceed to notice some of the new agents of most repute that have sustained in whole or part the reports first made of them.
Ailanthus glandulosa, or Tree of Heaven.
This tree is a rapid grower and extensively cultivated as an ornamental tree and has a very fetid and sickening odor. It is said to be of value in asthma, dysentery, epilepsy, diarrhoea, etc. A tincture of the bark of the fresh root—eight ounces to the pint of dilute alcohol—is the best preparation for dispensing.
Dose, twenty to thirty drops every two to three hours.
In overdoses it produces vomiting and relaxation with deathlike sickness. It deserves further investigation.
This is a tree growing in Australia, and I am convinced it is a valuable antiperiodic. I have treated chronic intermittents successfully with it that would not yield to anything else tried. If given with quinina or cinchonidia in equal proportions, the antiperiodic effect is enhanced, while the secretions appear generally to be stimulated to normal activity, and the nervous system made quieter. In combination with Macrotys, Gelsemium, Phytolacca, etc., it is of value in rheumatism. It should be thoroughly tested.
Dose, of the powdered bark: two to ten grains every three or four hours.
This is one of the new Californian agents introduced by Dr. J. H. Bundy. It is a good tonic and alterative and has been used with success in syphilis, diseases of the skin, amenorrhea, etc. It may be employed whenever a tonic and alterative is indicated in doses of ten to thirty drops of the saturated tincture or fluid-extract. In one case of tertiary syphilis, in which the lower extremities were covered with copper-colored spots from the knee down, I employed this agent with satisfactory results.
Rhamnus purshiana, or Cascara sagrada.
This is also from California and introduced by Dr. Bundy. It has been the occasion of no little controversy among druggists and pharmacists, but fully sustains its reputation. It was long known to the Spanish residents of the Pacific coast and used by them as a remedy in constipation and dyspepsia.
I obtained a quantity of the bark of Mr. James G. Steele, of San Francisco, which I made into a tincture—eight ounces to the pint of 76 per cent. alcohol. I used it as a laxative in doses of ½ to 1 drachm with great satisfaction. One patient, a lady with bilious headache accompanied with violent constipation, which had resisted the treatment of the best physicians in Little Rock, was promptly relieved by the remedy in combination with Berberis aquifolium. It should be given in small doses frequently repeated in constipation, as the large dose is too active and leaves the bowels, like other cathartics, in a more inactive condition than before.
Rhamnus alnifolia, or Southern Buckthorn.
This is a plant of the same genus as the Cascara. I have had it under observation three or four years, but have never given it a trial. A Methodist divine informs me that a medical friend of his used it successfully as a cathartic in bilious derangements. Dr. Davis, of Kentucky, calls attention to it in the Eclectic Medical Journal, 1881, as a valuable remedy in dropsy, but does not give its mode of action. In sensible properties it very much resembles the cascara. I called the attention of the Arkansas Medical Association to it, at their meeting in 1879.
Turnera aphrodisiaca, or Damiana.
This agent when first introduced was claimed to be a safe and reliable aphrodisiac, but does not seem to have sustained any very pronounced reputation in that direction. This is owing, it is asserted, to the employment of the wrong or a spurious article. Indeed, Dr. King, in the Supplement to the American Dispensatory, says there are three different kinds of Damiana on the market, which shows the above assertion to be not altogether unfounded. I have employed the California variety obtained from Mr. James G. Steele and am very sure it has no aphrodisiac properties, but it is valuable as a kidney tonic, if I may be allowed to coin such a term. A boy highly anemic and dropsical from chronic intermittent, was not benefitted in the least from the employment of bitter tonics and iron, nux, etc. I tested his urine and found that the red particles of the blood were insensibly escaping by the kidneys. I added Damiana to the prescription, and he made a satisfactory recovery. I believe that the credit of discovering this medicine belongs to Dr. Hammond, of the Georgia Eclectic Medical College. I do not know which variety he used.
Further investigation is necessary not only to determine the relations, but therapeutic value of the different varieties.
Gentiana quinqueflora, or Five-flowered Gentian.
This agent was brought to notice about the year 1866 by Dr. Yelvington, of Susquehanna, Pennsylvania, who describes it as tonic, cholagogue, and antiperiodic. In this last report he considered it equal to quinia if not superior in chronic intermittents. It is mostly found on the Susquehanna river, Pennsylvania.
My friend, Prof. A. B. Woodward, of Tunkhannock, Pa., sent me two pounds of the herb two or three years ago, which I made into a tincture, eight ounces to one pint of 76 per cent. alcohol. It is intensely bitter. Prof. W. gives the following specific indications for its use: "A dirty, yellow tongue, inclined to be chilly; pain in the head, especially frontal; with any feverish condition." I used the tincture as prepared in doses of five to twenty drops once in two hours, and found it would clean the tongue in twelve to twenty-four hours. When given in the larger dose, however, it would often leave the tongue fiery red, and I believe if continued in this way would cause inflammation of the stomach. Small doses of five to ten drops have given me the most satisfaction. If it is associated with other remedies, as for example, sedatives, cathartics, tonics, alteratives, etc., it is said to increase their action.
Prof. W. claims to have had excellent results from it in bilious and other headaches, congestive chills, etc. My experience with it has been limited, but I regard it as an agent of great value.
Nyssa multiflora, or Black Gum.
I called the attention of the profession to this tree in the Eclectic Medical Journal, 1880, page 447, directing attention to its anti-abortive and parturient properties. Since that time I have had little experience with it. In one case of uterine inertia, it excited the contractions, but they soon subsided. I gave 1 to 2 drachms every fifteen minutes. Perhaps a larger dose would have been more effective. Its action very much resembles that of Cimicifuga. The pains produced by it resemble the natural efforts. The preparation I used was a tincture of the bark 8 ounces to dilute alcohol 1 pint. The midwives, so far as I know, throughout this country, have a knowledge of it.
Polymnia uvedalia, or Bear's Foot.
I called attention to this agent also about 1869-70. I had spent a great deal of time in its study and investigation, history, etc., and wrote several articles in the Eclectic Medical Journal in regard to it, which brought me a voluminous correspondence. Such a demand was created that I was compelled to gather it in quantities to supply the demand, till druggists could get it into the market. It was manufactured into a saturated tincture from the recently-dried root, with 90 per cent. alcohol, and an ointment with hog's lard.
The tincture was given in doses of five to thirty drops three to four times per day, and the ointment applied externally with brisk friction two or three times per day, bathing it in with a hot smoothing iron in bad cases. In cases of enlarged spleen—"ague cake"—its action is the most prominently displayed, and in this disease it surpasses, in my hands, every other agent I ever used. I never prescribe anything else. I succeeded with it in one case of twenty-eight years' standing. I have used it in almost every variety and form of chronic disease incident to this country, and it has given me more satisfaction than any single remedy I ever used.
It is alterative, stimulant and subtonic, par excellence. It is not adapted to acute cases. The specific indications are as follows: A bloated, sodden appearance of the body, yellowish, dirty-looking skin-what we call in Arkansas "tallow face,"—a languid, sluggish circulation, enlarged glands, etc.
The best time for collecting it is after the seed ripens, till frost appears. After the top has been killed by the frost it is not so good. The root should be cut in small pieces and dried quickly in the sun.
I will briefly relate two cases treated with it, not before reported.
While I was visiting my brother, in the summer of 1876, in Yell county, a lady of the neighborhood consulted me in regard to her husband. She explained that "he was confined to his bed with a severe pain in his hip." Perceiving that it was sciatica of a rheumatic character, I told her I had no medicines with me and declined to visit him. She then asked me whether I could not tell her of something that would help him. I recommended the Polymnia in whiskey in the same way that poke-root is used by the country-people for rheumatism; also an ointment of the same. I saw the patient the next fall. "I was up and plowing in a week," he declared to me "the ointment relieved the pain right off."
As I returned home from my brother's, a near neighbor of his, requested me to stop and see his children. He showed me a girl between twelve and fourteen years old, whose head was nearly covered with tinea capitis. There was also considerable enlargement of the cervical lymphatic glands. The family had been using red mercurial ointment freely, but without benefit. I said to him: "Squire G. I think I could cure your girl if I had her where I could see her once or twice a week." He enquired whether I "could not recommend something that would help the child." With a laugh I told him of the Polymnia. He said that he would try it. I enquired of the gentleman above referred to about the girl. "Well, sir," said he, "that girl is well and has as fine a head of hair as you ever saw."
This agent was introduced to the profession by Dr. J. T. McClanahan, of Boonville, Missouri, who insists that it is a specific in enuresis, or "bed-wetting" of children, kidney-troubles, diseases of the bladder, hemorrhages, either active or passive. The doctor sent me about eight ounces of the bark of the root which I made into a one-pound tincture. This I used in two cases of "bed-wetting" in children, with good effect. It only lasted, however, while the remedy was continued. Perhaps if given longer the effect would be permanent. I also used it in one case of passive menorrhagia with benefit.
This is another of the new Californian plants, introduced to the profession and pharmacists by Mr. James G. Steele, though it had been noticed before by others. I obtained a quantity of the herb from him which I made into a saturated tincture with strong alcohol. This I have been using in asthmatic and bronchial affections with good results.
I also obtained a quantity of this herb from Mr. Steele. My experience with it has been too limited to justify an opinion. The few cases, however, of intermittent and enlarged spleen in which I used it were not benefitted.
Piscidia erythrina, or Jamaica Dogwood.
This is offered as a substitute for opium and its preparations, as an anodyne and hypnotic. From the trials I have made with it, I am inclined to think favorably of it. Dose of the fluid extract: ½ to 2 drachms; repeated if necessary.
Dr. George, of California, two or three years ago sent me two pounds of the root of this plant, saying it was "stimulant, astringent, tonic, and anti-emetic" and of value in fevers. I used it in several cases of diarrhoea both acute and chronic with happy effect; also in a few cases of nausea and vomiting. I prepared the tincture, 8 ounces to dilute alcohol 16 ounces, giving it in doses of ½ to 2 drachms every two or three hours. The tincture deposits a heavy precipitate upon standing.
This is also from California. The first trial I made with it was with a fluid extract obtained from Mr. A. A. Miller, St. Louis, upon myself After recovering from a protracted attack of typho-malarial fever in the summer of 1877, with several bronchial complications, it developed into a well-defined chronic bronchitis. I took the medicine in doses of ½ to 1 drachm four times a day, mixed with glycerine and water, and am happy to report a perfect and permanent cure. Since that I have used it in bronchial, laryngeal, and pulmonary complaints with excellent effect. I have also used it in combination with the Grindelia Robusta in asthma, chronic pneumonia, etc., with good effect.
I would recommend further investigation and experimentation with these articles. Not only should the present discoveries be more permanently established, but other qualities brought to light that we have not ascertained.
Every region of our country contains more or less medicinal plants. It is a pleasant and profitable pastime in which one can spend his leisure time, in the study and investigation of the medical flora of his neighborhood, in connection with the practice of office-pharmacy. To ascertain the effect of any given article we should experiment upon ourselves with small doses, or on some domestic animal, noting its physiological effect. We will then see and feel how and when it acts. Any disease presenting similar symptoms may be benefitted by it.
Transactions of the National Eclectic Medical Association, Vol. X, 1882-83, edited by Alexander Wilder.