Bryonia (U. S. P.)—Bryonia.

Fig. 50. Bryonia dioica. Photo: Bryonia dioica 9. Preparations: Fluid Extract of Bryonia - Tincture of Bryonia

The root of Bryonia dioica, Jacquin (Bryonia alba, Hudson), and Bryonia alba, Linné.
Nat. Ord.—Cucurbitaceae.
COMMON NAMES: Bryony, Snakeweed, Devil's turnip, Bastard turnip, Parsnip turnip.
ILLUSTRATION: Woodville's Med. Bot., Plate 187.

Botanical Source.—The species used in medicine are Bryonia dioica and Bryonia alba. The genus to which they belong is a family of herbaceous vines, climbing by means of tendrils. The species, of which there are about 50, are found in most parts of the Old World. They are distinguished from the allied plants of the natural order Cucurbitaceae, by having the flowers monoecious, or occasionally dioecious, the 5 stamens united into 3 bundles, and the fruit globular and berry-like.

Bryonia dioica belongs to the section of the genus Bryonia, with palmately lobed leaves. It is common among the hedges and in the borders of woods in Europe, especially in the calcareous soil of some parts of England, where it is quite ornamental. The stem, which is a rough annual, climbs to the height of several feet above hedges and undershrubs; the leaves are cordate and 5-lobed, the terminal lobe being longer than the others, and dissimilar. The flowers are of a light, greenish-white color, with darker green veins; they are perfectly dioecious in the young plants, although both sexes are often found on older individuals. The fruit is a bright scarlet berry (red bryonia), with several flat seeds.

Bryonia alba is a closely related plant, found in Central Europe, Sweden, and Denmark. It has white flowers, regularly lobed leaves, and black berries (Black bryonia). These two species of bryonia must not be confounded with the black bryony (Tamus communis), a European plant of the natural order Dioscoreaceae.

History and Description.—Bryonia has been used in medicine throughout sections of Europe for a great many years, and occupied a conspicuous place in the London Dispensatory, published in 1653. It is vulgarly known as snakeweed, devil's turnip, parsnip turnip, and bastard turnip. The root, the part employed, is from 2 to 4 inches in diameter, and about 2 feet in length, although occasionally larger. It is fleshy, and when wounded, yields a milky juice. Internally it resembles the root of Phytolacca decandra, maintaining the similarity when sliced and dried.

As found in our market, bryonia is in slices, often worm-eaten, or even decayed, and totally unfit for use. It is said that the purgative principle (Bryonin), is stable, but, undoubtedly, even though this be the case, it can not withstand the attacks of time and the ravages of insects, for tinctures prepared from inferior specimens will not give satisfaction. The Pharmacopoeia describes the drug from both species as follows: "In transverse sections about 5 Cm. (2 inches) in diameter, the bark gray-brown, rough, thin, the central portion whitish or grayish, with numerous small, projecting wood-bundles arranged in circles and radiating lines; fracture short; inodorous; taste disagreeably bitter"—(U. S. P.).

Chemical Composition.—In 1858, G. F. Walz published an article upon the chemical composition of Bryonia alba (Archiv. der Pharm., cxlvi), the result being the identification of two white, crystallizable bodies, bryonin and bryonitin. The latter substance, however, was, in 1862, admitted by Walz not to be an individual body, but merely a mixture of a crystalline, fatty acid, and some saponifiable fat (Amer. Jour. Pharm., 1862). To obtain bryonin from the root, an alcoholic extract is made of the latter, and the resulting product, after evaporation, is treated with water. After extraction of the aqueous extract with ether, bryonin, with impurities, remains in the residuum, and may be obtained by dissolving the residuum in water, precipitating the coloring matter with acetate of lead, the excess of which must be removed with sulphide of hydrogen; after filtration, neutralize the filtrate with carbonate of sodium; then precipitate with tannic acid, dissolve the precipitate in alcohol, digest with calcium hydroxide, filter, digest with animal charcoal, again filter, and evaporate. Bryonin is a colorless powder, very bitter, soluble in water and alcohol, and insoluble in ether and in chloroform; when boiled with diluted sulphuric acid it assumes a bluish tint, splits into sugar and two bodies named by Walz, bryoretin (soluble in ether), and hydrobryotin (insoluble in ether). Walz's analysis would point, for bryonin, to the formula C25H42O10, while Masson, in 1893, arrived at the formula C34H48O9. Starch, sugar, gum, wax, fatty constituents, albumen, cellulose, and salts, are also present in the root.

Action, Medical Uses, and Dosage.—The fresh root of bryonia is extremely irritating, occasioning blisters when bruised and kept in contact with the skin, and causing serious gastro-intestinal inflammation when taken internally. A profuse and uncontrollable diarrhoea, vomiting, vertigo, reduction of temperature, dilatation of the pupils, cold perspiration, extremely small pulse, colic, collapse, and death have resulted from its use. Its influence on the nervous system is marked. A similar result follows the administration of large doses of the dried root. An infusion of galls is said to antidote it. This root appears to have been well known to the ancients, and was used in various maladies. It has likewise been employed in more recent times in convulsions due to the presence of worms in the intestines, as a cathartic in dropsy, and in cases of chronic inflammations, attended with glandular enlargements, or serous effusions. It is chiefly used at the present day in small doses, as a remedy in acute and chronic serous maladies, in glandular enlargements, in scarlatina to lessen the tendency to aural complications that may terminate in otorrhoea and deafness, in chronic orchitis, in chronic rheumatic affections, pleuritic and pulmonic disorders, fevers, etc., and to overcome constipation and regulate the bowels.

The indications for bryonia, according to Prof. Scudder, are "a hard, vibratile pulse, flushed right cheek, frontal pain extending to the basilar region, and irritative cough." Perhaps no remedy in the whole range of respiratory therapeutics is more valuable than this one, and much of the success of Eclectic physicians in the treatment of lung diseases is the result of the frequent use of specific bryonia. It is the remedy for the sharp, cutting, and lancinating pain with harsh cough. It is equally valuable when the pain is tensive and tearing, especially when aggravated by motion; the parts feel stiff, sore, or bruised, and there is a large quantity of mucus within the bronchioles, as evidenced by the loud mucous rales. When the pulse is hard, frequent, and vibratile, and the temperature is elevated, bryonia is indicated. A prominent indication is the flushed right cheek just above the malar bone. It acts best in small doses. It frees the circulation, overcomes capillary obstruction, lowers temperature, and controls pain. It is the remedy for inflammation of serous tissues, and is equally valuable in peritonitis and in synovial inflammations. It lessens nervous excitation and erethism, and promotes secretion and excretion. In rheumatic conditions of the chest and in pleurodynia, it is valuable, especially if the pain be sharp, and is aggravated by motion. Its best results are observed in pleurisy. In simple pleuritis from cold aconite alone is sufficient; but that form of pleurisy which is insidious and complicated, is best treated with bryonia, and in the second stage it hastens the removal of effused material. In the so-called "bilious" pleurisy, with jaundice and a burning sensation in the lungs, and tenacious mucous expectoration, it proves an excellent drug. In pleuro-pneumonia it may be given for its absorptive qualities. Bronchitis, with frothy, blood-streaked expectoration; pneumonia, with sharp pleuritic pain, or with harsh, harassing cough; and in cough aggravated or excited by talking, walking, or tickling in the throat, or by vomiting, it is always indicated. It is beneficial in typhoid pneumonia, but should be associated with baptisia. It is valuable in phthisis is to control pain, lessen temperature, and to allay the troublesome cough. Probably no remedy, excepting gelsemium, was so frequently indicated to control cough and pain in the recent epidemics of "la grippe." In nearly all cases in which bryonia is employed it should be associated with aconite, veratrum lobelia or gelsemium, as indicated. As a remedy for cough, independent of broncho-pulmonary complications, it is valuable where the trouble originates in the larynx and trachea, especially that painful cough seemingly located between the suprasternal notch and the bifurcation of the trachea. Such a cough is irritative, and generally due to a nervous erethism, which is controlled by bryonia. The cough is dry, rasping, hacking, or explosive, and always attended with more or less tensive or sharp pains. But little, if any, secretion is present, unless it be a small quantity of white or brown, blood-streaked or clotted, frothy mucus. Tickling, irritative cough, aggravated by swallowing food, talking, or upon entering a warm room—the kind of cough produced by cold—is always benefited by bryonia The bryonia condition is one of debility, and the patient perspires readily. It is a remedy for fevers, and will often control them when the special sedatives fail. Chilliness, with a sensation of tension, and that form of cutaneous weakness in which one easily sweats, upon movement, are the conditions for it. Add to this the peculiar bryonia pain, given above, and deepened color of mucous tissues, and full veins, evidencing capillary obstruction, frontal headache, dry tongue, and tendency to delirium—and the bryonia case is complete.

"Aggravated by motion" has long been a phrase applied to bryonia cases, and so we find in these cases a lethargy induced more by a desire to remain quiet than one of dullness, as is noticeable when belladonna is required. The patient is languid, torpid, tired, and has little inclination to go about. A general deficiency of nervous balance is observable, and every effort tends to induce perspiration. With this may or may not be associated the bryonia headache, pain from the frontal region to the occipital base; thinking is an effort, and the patient is irritable if disturbed. Temperature is slightly increased, and the tissues contracted. When any special organ is affected, extreme tenderness and soreness is experienced upon pressure. Thus in hepatic disorders with jaundice, high-colored urine, and developing pain upon pressure, it is an excellent drug. Stitching, sticking or cutting pains about the liver, as if the serous capsule were involved, also indicates bryonia. In acute rheumatism, especially where the joints are swollen and feel stiff, it is direct in its action, and is equally valuable in chronic cases; painful and stiff rheumatism of the spine in children, rheumatic headache, sharp, temporal pain, frontal headache, hemicrania, with tender scalp, and sharp, tearing pains, made worse by motion, are all conditions for this drug. According to Prof. Locke, it is an absolute specific in rheumatic swelling of the finger joints. It is a remedy for ovarian and menstrual wrongs, with soreness on pressure. Acute mammitis is usually controlled by phytolacca, but when very painful and with elevated temperature, and the mammary glands are swollen, tender, and knotted, bryonia and aconite should be associated with the former.

Partial deafness from cold, or from scarlet fever with swollen glands; chronic orchitis, rheumatic paralysis, scrofulous conditions of the ears and eyes, and scrofulous ulcers and white swelling, with stinging, burning pain, are relieved by bryonia (Locke). Tensive pains in the ear in children call for bryonia. Prompt results were obtained from bryonia in an inveterate case of facial neuralgia of 6 years standing, by Prof. W. B. Scudder (Ec. Med. Jour., p. 144, 1894). The patient had a weak heart, and cold hands and feet, a countenance like one accustomed to morphine, and fugitive, lightning-like pain, involving the left side of the head and left eye, coming on at intervals of a half minute, and lasting a few seconds. So severe was the pain that the patient had to grasp a chair to support himself during the paroxysm. A peculiarity of the case was a hyperaesthetic spot upon the upper lip and gum the size of a silver dollar, so sensitive that even the contact of a soft cloth could not be borne. Bryonia is the remedy for rheumatic iritis, with aching soreness upon movement of the eyeball; also in non-edematous puffiness of the upper eyelid.

Bryonia seems to be a valuable heart tonic in weak and delicate individuals, who, by overwork and nervous excitation bring on a depressed and irregular heart-action (heart-strain); and even in organic heart troubles when exposure and rheumatic twinges bring on the cardiac paroxysm, bryonia, with rest in bed, is asserted to powerfully and rapidly influence the condition for good.

In peritonitis the pain requiring bryonia is of the character of colic, but is marked by unusual tenderness and tension. Bryonia is valuable in pericarditis tending to hydropericardium, and in brain disorders with serous exudation.

Bryonia should not be forgotten in ordinary indigestion, where the food lies heavily, as if a stone were in the stomach. Ordinary jaundice is often cured with it, and in typhoid fever, as soon as pulmonic complications ensue, the patient should be put upon bryonia. Some cases of infantile constipation are said to be benefited by bryonia, especially such as are due to gastric disorders arising from difficult digestion of cow's milk. It does not, however, benefit all cases. Scudder calls especial attention to its use in the abdominal tenderness and pain in typho-malarial fever, and zymotic diseases, and associated with ipecac or euphorbia in cholera infantum with abdominal tension and tenderness, or articular pain and swelling (Dis. of Child., p. 31).

Bryonia should never be given in large doses. The usual prescription reads Specific bryonia, gtt. v to x, aqua fl℥iv. Dose, a teaspoonful every 1 to 3 hours, as indicated. Some, however, and Prof. Locke particularly, prefer the first decimal dilution of specific bryonia, of which from 5 to 20 drops should be added to 4 ounces of water, and the dose of which is 1 teaspoonful. Tincture of bryonia may be given in doses of a fraction of a drop to 1 drop.

Specific Indications and Uses.—Sharp, cutting, lancinating, or tearing pain, from serous inflammation; pain in serous cavities, with muscular tension and tenderness on pressure; tensive, sharp, tearing pain, with a sore feeling in any part of the body as if bruised, and always aggravated by motion; dry, sensitive skin; hard, moderately full, or hard, wiry, vibratile pulse, tensive rheumatic pain, made worse by motion; headache on right side, with flushed right cheek above malar bone (a prominent indication); frontal pain extending alongside of head to basilar region; hyperaesthesia of face or scalp; head so sore that one can not bear to be touched; pleuritic pain; neuralgic pain with hyperaesthesia; irritative, hacking, rasping, or explosive cough, with soreness or bruised feeling of parts, and with laryngeal and suprasternal soreness and tenderness; abdominal pain with tenderness; ocular tenderness, increased by movement; tensive earache; articular and synovial pain, swelling, and tenderness; bowels 'constipated and urine scanty; burning in eyes and nose, with acrid nasal flow; apathy or lethargy short of dullness, from disinclination to move on account of aggravation of condition; tired, weary feeling, too tired to think; disposition to perspire on the slightest movement.

Related Species and Drugs.—TAYUYA ROOT. This Brazilian root is said to be that of the Trianosperma ficifolia. It is proposed as a remedy for scrofula, tertiary, syphilis, dropsy, paralysis, and stubborn skin diseases. Dose of tincture, 5 to 15 drops.

Bryonia africana, Thunberg. South Africa. Used like bryonia.

Bryonia americana, Lamarck. West Indies. Employed for same purposes as bryonia.

Corallocarpus epigaea, Hooker filius (Bryonia epigaea, Rottl.). A native of Java, and considerably employed by the natives of India, where it is found also, as a valuable remedy for snakebites, dysentery, and syphilitic disorders. The tuber is somewhat turnip-shaped, large, often weighing 5 or 6 pounds, has a subacid, bitter taste and is mucilaginous. The viscid juice which exudes upon cutting the tuber hardens into an opalescent gum. The root is cathartic and anthelmintic. M. Jules Lepine, of Pondicherry, found in it a yellow bitter body refusing to crystallize, and thought to be probably identical with bryonin (Dymock, Mat. Med. of Western India).

Bryonia laciniosa, Linné, also found in India, is aperient and tonic. The whole plant, in fruit, is used.

King's American Dispensatory, 1898, was written by Harvey Wickes Felter, M.D., and John Uri Lloyd, Phr. M., Ph. D.