Source and Composition. The tops of Cytisus Scoparius, the common "Broom," a well-known garden shrub of the nat. ord. Leguminosae. It contains a neutral, crystalline principle, named Scoparin, and a liquid, volatile, poisonous alkaloid, Sparteine, which contains no oxygen, but has decided basic qualities.
- Extractum Scoparii Fluidum,—has diluted alcohol. Dose, ʒss-ij.
- *Decoctum Scoparii, Decoction of Broom, ℥j to the pint,—Dose, ℥j-iij, every 3 or 4 hours, until diuresis occurs.
- Sparteinae Sulphas, Sparteine Sulphate—Dose, gr. 1/16-½ hypodermically; gr. ss-ij by mouth. Small doses (gr. 1/16-¼) every 5 hours for cardiac action; larger (gr. j-ij) for diuresis. (Clarke.) Larger doses are necessary, say gr. jss-iij, thrice daily. (Prior.)
Physiological Action. Broom-tops are diuretic and laxative, also emetic in large doses. In decoction they have long been a favorite diuretic and vehicle for other diuretics in the treatment of dropsies, both cardiac and renal, but are considered most reliable in the dropsy of renal origin.
In small doses Sparteine slows and strengthens the heart-beats, and raises arterial tension, at the same time increasing the cutaneous and renal circulathou, so that the surface becomes flushed and moist, and in some cases marked diuresis and diaphoresis occur. The respiration, at first quickened, is soon slowed and deepened,—the patient having a sense of increased warmth and well-being, and if suffering from irregular cardiac action, praecordial distress and dyspnoea, these symptoms are promptly relieved. If the pulse has been abnormally slow Sparteine will quicken it, though its general action is to slow the cardiac rate. An overdose brings on marked palpitation, a small and rapid pulse of very high tension, praecordial pain and a sense of "tightness" about the chest, with anxiety, and a feeling of intense debility, perhaps even muscular tremor. Death occurs by asphyxia from depression of both the centre and the muscles of respiration.
Sparteine acts directly on the cardiac muscle, as well as upon the inhibitory apparatus, thus giving greater force to the cardiac contractions, and regulating (generally slowing) the pulse-rate. It also stimulates the vaso-motor centre to contract the vessels throughout the splanchnic area, thus increasing the circulation in the skin and kidneys, and raising arterial tension generally. Its diuretic power on healthy persons is denied by some observers and affirmed by others, though all acknowledge it in disease. It is accompanied by increased excretion of urea, is due to the increase of blood-pressure both behind and in front of the renal circulation, and is produced only by large doses.
Therapeutics. Sparteine has been employed with very great benefit in cardiac affections requiring stimulation of the heart's action with the smallest possible increase of arterial tension, relief of dyspnoea, praecordial pain, palpitation and oedema. In such cases small doses, (gr. 1/16-¼) are best, and as the influence of the drug is remarkably sustained, they need not be repeated for 5 or 6 hours. It has given the most marked satisfaction in—
- Mitral Regurgitation,—in which it relieves all the symptoms.
- Mitral Stenosis,—when the pulse is small, weak and irregular.
- Aortic Regurgitation,—it quiets excited action of the heart, without unduly prolonging the systole, and is of great value.
- Chronic Bright's Disease, with hypertrophy and high arterial tension,—it stimulates the heart without increasing the tension.
- Exophthalmos,—it gives remarkable relief to all the symptoms.
- Palpitation and Arhythmia,—small doses are of great service.
- Asthma—it is of signal benefit, cutting short the paroxysms, and rendering their recurrence much less frequent.
- Opium-habit,—it is used at period of depression during the treatment, to overcome the "plateau" shown in the sphygmograph trace.
A Compend of Materia Medica, Therapeutics, and Prescription Writing, 1902, by Sam'l O. L. Potter, M.D., M.R.C.P.L.