The leaves of Atropa Belladonna.—Europe.
Preparations.—Tincture of Belladonna. Extract of Belladonna. Atropia.
Dose.—The dose of the tincture will vary from the fraction of a drop to five drops. For its specific use we add gtt. v. to gtt. xx. to water ℥iv., and give a teaspoonful every hour. The extract may be used in doses of from gr. 1-20, to gr. 1-2, according to the action desired. The dose of Atropia is from gr. 1-100 to gr. 1-20.
Specific Indications.—The patient is dull, inclined to sleep, the eyes are dull and pupils dilated—the condition of congestion of the brain, of which coma is a further symptom. Impairment of the capillary circulation with congestion, in any portion of the body, is an indication for Belladonna. The skin is red, and the finger drawn across it leaves a somewhat permanent white line; dusky redness of the surface from capillary congestion, calls for Belladonna. A very free flow of urine—diabetes insipidus—is an indication, as is deep aching of the loins or back with sense of fullness. A dull heavy headache, with a feeling that the person could go to sleep if it were not for the pain, is a common indication.
Therapeutic Action.—Belladonna is sedative, narcotic, antispasmodic, diaphoretic and diuretic, and is a powerful narcotic or cerebro-spinant. It greatly diminishes the sensibility and irritability of the system when morbid states obtain, and in the healthy state its effects are as follows. It occasions dryness of the mouth and throat, thirst, visual illusions, dilated pupils, giddiness, delirium, singing in the ears, or impaired hearing, numbness of the face, difficult deglutition, and articulation, sense of constriction about the throat, nausea, occasionally vomiting, a cutaneous eruption like scarlatina, and an increase of the cutaneous, renal and mucous secretion.
If the quantity taken be large, the pupil becomes largely dilated and immovable, and the eye quite insensible to light, conjunctiva injected, tongue, palate, and throat dry, deglutition difficult, nausea, prostration, difficulty or inability to maintain the erect position, constant movement of the hands and fingers, delirium or intoxication, a red and tumid face, sometimes fits of laughter, and sometimes furious delirium; finally the patient becomes comatose, the stomach and bowels lose their impressibility or normal sensibility, and the whole nervous system seems to be paralyzed. "A feeble pulse, cold extremities, subsultus-tendinum, deep coma or delirium, and sometimes convulsions, precede its fatal termination."
In the modern practice of medicine we employ it as a remedy for congestion. It stimulates the capillary blood-vessels in all parts of the body, but more especially in the brain and spinal cord.
In congestion of the brain it has no equal. The patient is dull, and inclined to sleep most of the time, the face is dull, expressionless, the eyes are dull, the pupils are dilated. Where the face is flushed the color is dusky. This it will be remembered is a common complication in the acute diseases of children, and with the old means of cure are unfavorable conditions. We meet this condition now with small doses of Belladonna, gtt. v. to gtt. x., water ℥iv.; a teaspoonful every hour.
In very small doses, gtt. ij. to gtt. v. to water ℥iv., a teaspoonful every four hours, it is a prophylactic against scarlet fever. Not that it will antidote the contagion in all cases, for we must be satisfied if it will do it in a part. I have been called to a first case of scarlet fever in a family of four to eight children, and with the prophylactic administration of Belladonna, have had no other cases, or but one or two more. I have used it in my own family with these results.
But if it does not prove prophylactic, it will have done no harm, and indeed I have thought when Belladonna had been taken the disease was much milder.
Belladonna is a valuable remedy in diabetes insipidus, and even in diabetes mellitus it checks the flow of urine in some cases. It relieves the unpleasant sense of fullness and weight in the loins and the weak back. In some cases a Belladonna plaster applied to the back across the loins, will have this effect.
It is a valuable remedy in sore throat, whether diphtheritic, scarlatinal, or the ordinary sore throat. For this purpose it may be administered with Aconite, Phytolacca, or alone.
In chronic disease of the brain, with sense of fullness, dizziness, drowsiness, dull heavy aching, it is an admirable remedy. It is to be thought of when indications of apoplexy are observed, there being the dull eye, dilated pupil, and drowsiness.
It is the remedy for headache, when the pain is dull and heavy, and the patient feels sleepy.