Thuja.—Arbor Vitae.

Fig. 245. Thuja occidentalis. Photo: Thuja occidentalis 1. The branchlets and leaves of Thuja occidentalis, Linné.
Nat. Ord.—Coniferae.
COMMON NAMES: Arbor vitae, Yellow cedar, False white cedar, Tree of life.

Botanical Source.—This evergreen tree is indigenous to this country, growing wild in various parts of the United States, from Canada to the Carolinas, on the rocky borders of streams and lakes, and in swamps, flowering in May. It abounds especially in Canada and the northern states. The trunk of the tree is crooked, rapidly diminishing in size upward, throwing out recurved branches from base to summit; branches ancipital, flat, and broad. The wood is very light and soft, but exceedingly durable. The leaves are evergreen, rhomboid-ovate, with a gland on the back, squamose, appressed, and imbricated in 4 rows. The cones are terminal, oblong, and nodding; the scales pointless and 1-seeded; the seeds broadly winged (W.—G.).

History and Description.—The thuja, a well-known coniferous tree, attains a height of from 20 to 50 feet in its native habitat, which is in cold and wet swamps, growing among the tamarac and other allied species, or in wet, rocky situations. It is commonly known as Yellow cedar and (wrongly) White cedar, the latter name properly belonging to another tree, the Cupressus thujoides. It is best known to the public in general, when cultivated for ornamental gardening, as it frequently is, as the arbor vitae, or "tree of life." When thus cultivated and neatly trimmed, it has a much more compact appearance than in the wild state, as in the latter the branches and leaves have a somewhat loose and straggling appearance. The wood is light, fine-grained, and soft, being somewhat resinous, and is very durable. The twigs and small leaflets of this tree furnish the drug of commerce.

Thuja has been used in medicine to a slight extent for two centuries at least. Boerhaave lauded the distilled water of thuja as a remedy for dropsy. Homoeopathy is indebted to Hahnemann for its introduction into that school. Schoepf states that it is useful in coughs, fevers, scurvy, and rheumatism. Peter Kalm, a Swedish traveller and collector of American plants, after whom our drug Kalmia is named, states that, in Canada, the bruised leaves were applied locally to relieve the pains of rheumatism. Parkinson advised the eating of the leaves and young sprouts on buttered bread to bring about the "expectoration of tenacious and vitiated humors." In the early part of the present century, the oil of thuja was employed as an anthelmintic and taenicide. Its use for this purpose, however, is dangerous, owing to its liability to produce a violent irritation of the gastro-intestinal tract.

The use of thuja by the Eclectic profession is of comparatively recent date. The first published account of its use by one of our school is in the Eclectic Medical Journal for 1862, though it was, undoubtedly, personally used by other Eclectics. In an editorial, the editor, Dr. Scudder, gives the experience of Dr. Dickey, of Preble County, Ohio, who used it as a discutient in scrofulous enlargements of the lymphatic glands. Equal parts of powdered Podophyllum peltatum were incorporated with thuja sprouts, and made into a poultice with milk. The same treatment was pursued in severe neuralgia and rheumatic complaints, affording great relief. In one case, in which the patient had been bed-ridden for over a year, in consequence of severe pain and weakness in the lumbar region, a speedy and complete cure was effected. How much of the relief came from the heat and moisture of the poultice does not appear, but as the doctor had exhausted his therapeutic resources, it is fair to presume that the relief was in part, at least, due to the thuja. The leaves and twigs are employed. They have a pleasant benzoinic odor, and a pungent, bitterish. aromatic taste. A yellowish, green, pungent, aromatic, essential oil may be procured from them by distillation. Water or alcohol extracts their virtues.

Chemical Composition.—The leaves and tops of thuja yield, by distillation with steam, about 0.5 to 1 per cent of volatile oil (Oleum Thujae, Oil of Arbor Vitae). It is colorless or green-yellow, has a bitter 'taste, and a strong, camphoraceous odor, resembling that of tansy. According to Jahns (1883) and Wallach (1892-1894), it contains chiefly dextro-pinene, laevo-fenchone, and dextro-thujone (see Gildemeister and Hoffmann, Die Aetherischen Oele, 1899, p. 344). Other constituents of the leaves of thuja are a bitter glucosid, pinipicrin (also contained in Pinus sylvestris), and a peculiar, astringent, yellow coloring matter, thujin (C20H22O12, Rochleder and Kawalier, 1858), which is also a glucosid, closely related to quercitrin; with diluted acids, it splits into sugar and thujigenin (C14H12O7), the latter takes up water and becomes thujetin (C14H14O8). With barium hydroxide, thujin is decomposed into sugar and thujetic acid (C28H22O13). (For experimental details regarding these bodies, see Husemann and Hilger, Pflanzenstoffe, 1882, p. 331).

Action, Medical Uses, and Dosage.—Thuja was occasionally employed by doctors in the earlier years, but few new uses for it were developed. Like nearly all the drugs, which are not so dangerously active as to force themselves on the practitioner's notice, it only needed some conspicuous authority to announce the virtues of the remedy. The late Prof. Howe believed the drug valuable. It would seem that he was especially partial to the conifers. He reintroduced Pinus canadensis and thuja. Its present extensive use is largely due to his advocacy of the drug. It is true that Prof. King described thuja in the earlier editions of the American Dispensatory, and stated that a decoction of the leaves had been used in remittent and intermittent fevers, coughs, rheumatic and scorbutic affections, and gave the usual notice respecting its power to remove warts. With the exception of the latter use, this gave nothing further than Schoepf's statement.

Prof. Howe was desirous of seeing the remedy fully tested, so he began with the drug to determine its true value. In the Eclectic Medical Journal for 1880, p. 331, he gives a brief compilation of Eclectic uses of the drug, and concludes with his knowledge of it, and a notice of his intended lines of investigation. He says: "A tincture of fresh leaves of thuja will, locally applied, according to my experience, remove warts from the face and hands, condylomata about the nates, but will not destroy swiftly growing venereal warts. It will deaden fungous granulations, and utterly destroy them in some instances. But the best action of the drug is in overcoming the growing and spreading progress of epithelioma. I have seen it repress and overcome fungoid and ulcerous epitheliomata in an astonishingly happy manner." He further intimates that he shall try it in croupous and diphtheritic cases, and states that he shall inject some of the tincture into the tunica vaginalis testis for the cure of hydrocele, and may try it on the granulations of trachoma. Finally, he would see what could be done to a bulging naevus with it. Having carried out the last intention, he records his success (Ec. Med. Jour., 1880, p. 391):" In the treatment of naevi, I feel that a specific has been brought out. I do not expect that it will take out the scarlet color of those vascular patches, called mother's mark, but that the agent will cause to shrink to insignificance those puffy naevi, which once called for the ligation of arteries. The thuja treatment is so safe and simple that a surgical operation is uncalled for, the operating surgeon losing by the discovery." Later, in the Eclectic Annual, he stated that, externally applied, it would lessen the size of a naevus or mother's mark. Many failures have been recorded in its use for the latter purpose. Thuja comes highly recommended as a dressing for sloughing wounds, ulcers, bedsores, senile and other forms of gangrene, serving a useful purpose in overcoming the horrible stench arising therefrom. It may likewise be used in carcinomatous ulcerations. Some even claim that it has power to check the latter disorder, but in all probability, this is claiming too much for the drug. It is frequently valuable to restrain hemorrhages occasioned by malignant growths.

Thuja is antiseptic and stimulant. Its general action is very much like that of the terebinthinates, and is said to resemble savin more than any other drug of this class. For this reason, it has been employed, as before stated, in amenorrhoea, with pelvic atony, and also in catarrhal diseases of the female generative organs. We have used it with good results as a topical application to thick, spongy, or tender os uteri, with leucorrhoeal discharge. It is asserted that thuja has brought on abortion, acting not so much as a direct abortivant, but as a gastro-intestinal irritant, producing violent intestinal disturbances, giving rise, indirectly, to miscarriage. Thuja is a remedy for blood changes and glandular disorders. Tissue degenerations in the epithelial structures appear to be influenced by it. Good results have come from using an inhalation of thuja in bronchial diseases and catarrhal affections of a chronic type. We would suggest its inhalation in fetid bronchitis and bronchorrhoea. The preparation should be dropped on hot water and inhaled. It is first stimulant, afterward subastringent. It has successfully combatted hemoptysis. Its inhalation is serviceable in diphtheria and membranous croup. Rectal troubles, such as fissured anus and hemorrhoids, have been frequently cured with thuja. When it is thought necessary to inject a pile tumor, thuja may be used in preference to carbolic acid. It cures by inducing atrophy. In fissured anus, it is said that the drug at first aggravates the trouble, but, if persisted in, soon effects a permanent cure. Locally, or by hypodermatic injection, it has given good, but only temporary, results in vascular rectum, where, from a paralytic condition, the lower segment of the rectum bulges and sags, amounting almost to a prolapsus. Thuja is well known as Prof. Howe's specific for the cure of hydrocele. His method was to add to 1 ounce of warm, sterilized water 1 drachm of Lloyd's thuja. After tapping the sac, 2 drachms of this solution were then sent, hypodermatically, into the tunica vaginalis testis. The fluid was then squeezed into every part of the sac. At first some pain and considerable swelling results, but in a few days, if the work has been properly done, a permanent cure is accomplished. Alarming swelling has been reported in some instances operated upon in this manner, as well as some failures recorded. As before stated, Prof. Howe intimated that thuja might be applied to trachomic lids. Later, Dr. D. Thomas Long, of Topeka, Kan., employed a preparation of it in unctuous condition, now known as Long's thuja, with great success in the treatment of this disorder. The patient may be given a small box of the unguent and taught how to use it. Each application causes considerable smarting for a short time, accompanied by lachrymation, which, however, very quickly subsides, leaving no unpleasant after-effects. We have had excellent results in chronic trachoma from this treatment. Constitutional or tonic treatment may also be required. Perhaps, one of the best known properties ascribed to this drug, is its power to remove warts, whether of the hands, face, or genitals. Nearly every writer who has mentioned this drug, has reported success in this direction. Our experience from the local application of thuja to warts has been negative. Subcutaneous injection of it around the base of the growth has been recommended, and might be more effective than the preceding. Fearn (Ec. Med. Gleaner, 1894, from Calif. Med. Jour.) advises it where excrescences are sensitive and moist, with a foul-smelling secretion. Prof. Lyman Watkins, M. D., reports success with it in urethral caruncle. Ɣ Several physicians have called attention to the fact that specific thuja proves an efficient remedy for nocturnal enuresis. Dr. Price (Ec. Med. Jour., 1892) records interesting cases cured with this drug. Thuja was used first in 5-drop doses at bedtime, afterward reduced to 3 drops. Old men, with enlarged and greatly irritated prostate inducing a constant dribbling of urine, consequently staining the clothing and entailing much unpleasantness, are benefited by 5-drop doses of thuja. Another interesting report is that of Dr. George Herring (Homoeopathic World), who employed it for irritability of the bladder, in gouty and eczematous patients. One case in particular mentioned by him, was that of an old man of 87 years, who was nearly exhausted from weakness consequent upon broken rest and frequent rising at night to empty his bladder. Thuja (first dilution), in 2-drop doses, brought complete relief. Prof. Howe (Ec. Annual) states that thuja, in 6 or 6-drop doses, will generally cure enuresis of children, and will alleviate senile dribbling of urine, if no paralysis exists. It has been successfully employed in gleet, when the continuance of the discharge was dependent on granular urethritis. A favorite injection for gonorrhoea, particularly in the latter stages, and for gleet, is composed of aqueous thuja, 1 part; Lloyds colorless hydrastis, 1 part; water, 4 parts. The proportions maybe varied as desired. It gives tone to the bladder walls, and is particularly of value in dribbling or expulsion of urine in plethoric women, with relaxed bladder tissues, where even a cough or slight muscular exertion causes an expulsion of urine. Thuja is a topical remedy of unsurpassed value in syphilitic chancroid. For this purpose the aqueous thuja is to be preferred. If applied early it relieves the pain, checks discharges, and promotes rapid healing. It acts best where softness and moisture are present. The parts should be cleansed with a borax wash before each application. Upon hard chancres it has little or no effect. This form of thuja is also valuable as an application to post-nasal catarrh, and to shrink nasal polypi and other growths in the nose and nasopharynx. Locally and internally, it gives excellent results in chronic tonsillar affections, and in the milder forms of faucial and pharyngeal diphtheria. It is also of value in some chronic skin affections, showing a tendency to vegetations. Dr. Foltz (Dynam. Therap.) states that specific thuja (1/5 to 1/3-drop doses) acts upon the deep ocular tissues, and has been used in scleritis, episcleritis, sclerochoroiditis, and syphilitic iritis, with gummata on the iris; also externally and internally for the removal of tarsal tumors. Dose of specific thuja, from 1 to 20 drops; of aqueous thuja, 1 to 30 drops. Externally, Long's thuja, specific thuja, and aqueous thuja may be applied full strength, or diluted as required.

Specific Indications and Uses.—Enlarged prostate, with dribbling of urine in the aged; urine easily expelled upon coughing or slight muscular exertion; vesical, irritation and atony; enuresis of children; verrucous vegetations; trachoma; chancroid.

Related Drug.—CYPRESS OIL. From Cupressus sempervirens. Lauded in whooping-cough. Used by sprinkling upon the clothing, bed, etc., of the patient.

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