The root of Gelseminum sempervirens.—U.S.
Preparation.—A tincture of the green root.
Dose.—The dose will vary from the fraction of a drop to ten drops, according to the use and condition of the disease. Of the old tinctures made of the strength of from two to four ounces of the green root to the pint of whisky, the dose was from one-half to one teaspoonful.
Specific Indications.—Flushed face, bright eyes, contracted pupils, with increased heat of the head, and excited innervation, are the direct symptoms. These are the evidences of determination of blood to the brain, and it is to relieve irritation and stop determination of blood to the brain, that it is especially useful. Any evidence of irritation of brain, spinal cord, or sympathetic centers, may call for this remedy.
Therapeutic Action.—Gelseminum is sedative, febrifuge, antispasmodic and narcotic. When taken in medicinal doses we find that it producps relaxation of the muscular system, the muscles of the eye-lids being the part first affected, the patient having difficulty in opening the eyes; but if its use is continued, the entire muscular system is more or less affected; the pulse becomes less frequent and the secretions free. If the dose is excessive, there is complete prostration, almost entire loss of muscular power, dimness of vision, the pulse sinks to forty or fifty beats per minute and is very feeble, respiration slow and difficult, loss of consciousness, and in some cases death has resulted from it. It has been employed with great advantage in continued fever, given in doses of ʒj-of the old tincture, and gtt. x. of the new, repeated every two or three hours, until its full influence is produced. In these cases we find many times that its influence is very decided; it causes relaxation of the system; the pulse is less frequent and softer; the respiration is slower; the skin becomes cooler, soft and moist; there is less determination to the head, and if there was pain in it, it is reduced or entirely ceases, while at the same time we frequently notice an increased secretion of urine.
In the fevers and inflammations of child-hood, one of the most unpleasant complications met is this of determination of blood to the brain. The child is observed to be uneasy and restless, the head hot, the face flushed, the eyes bright, and pupils contracted. Gelseminum is the remedy in this case, and should be administered in the small dose, frequently repeated, with the proper sedative. Whilst it exerts a more marked influence upon the susceptible brain of the child, it is also the remedy for the adult with these symptoms.
In the treatment of intermittent and remittent fevers we meet cases (in some localities and some seasons a large number) where an antiperiodic dose of quinine can not be tolerated because of its exciting influence upon the brain. Here the patient is prepared for the antiperiodic by the administration of Gelseminum, and frequently quinine will only act kindly when combined with this remedy.
Gelseminum passes out of the body through the kidneys, and exerts a direct influence upon the entire urinary tract. It thus becomes a remedy in renal irritation, acute nephritis, vesical irritation and inflammation, and even in urethritis.
Gelseminum is a powerful antispasmodic, not only by relieving irritation of the brain and spinal cord, but also by its influence upon the motor tracts, and the relaxation of the muscular system which follows. The specific indications should be strictly followed in these cases, for we do not want to use a sedative when a stimulant is required. The evidences of coming convulsions in the forcible flexion of the hands, the sudden movements of the extremities or facial muscles, should be noticed at once, and met by this or other remedy.
It is a prominent remedy in the treatment of hysteria, meeting those cases which show irritation of the brain and spinal cord, with increased circulation. It will meet some cases of puerperal convulsions, but is not so powerful in this case as Veratrum, chloroform, or the hypodermic injection of morphia.
In obstetrical practice it will be found a remedy to remove nervous excitement (evidences of determination of blood to the brain), very painful but ineffectual uterine contractions with sense of heat and dryness. Scanty urine, with frequent desire to micturate and burning, is also an indication for its use. It is the remedy in rigidity of the os, it being thin, sharp and unyielding; in this case it causes relaxation and softness of the parts.
In neuralgia it will be found a valuable remedy if the specific indications are followed, this case being one of irritation of the nerve centers. In the olden time it was thought to be almost an infallible remedy for headache, and it is a good remedy in the cases named.