Atropa Belladonna. (Belladonna.)
Preparation.—Whilst for some purposes a solution of the Alkaloid Atropia will prove the best preparation, I prefer for general use an Alcoholic fluid extract of the recent plant, representing the crude article ounce for ounce. Of this the maximum dose will be one drop, but frequently one-fifth to one-half of this will serve a better purpose.
For hypodermic use, we employ a solution of Atropia, in the proportion of one grain to the ounce of distilled water. The dose would be five to ten drops. This is also the best proportion for use to dilate the pupil. As a collyrium. we would add ʒj. of this solution to ℥j. of distilled water.
The specific use of Belladonna is as a stimulant to the capillary circulation, especially of the nerve centers—a remedy opposed to congestion. My attention was first drawn to it by an article from Brown-Sequard, giving the results of his experiments with the drug, stating that with the microscope he had seen marked contraction of the capillaries following its use. It at once suggested itself to me, that if it would cause capillary contraction, it would be the remedy for congestion; and I at once commenced experimenting with it in this direction.
I well recall my first marked case: a boy about eight years old, suffering from malignant rubeola. The entire surface was swollen and dusky; the eyes dull; the pupils dilated; the face expressionless; breathing labored, and wholly unconscious for forty-eight hours. The administration of Belladonna alone (in small doses) was sufficient to restore consciousness, and a free circulation, with good appearance of the eruption, in twenty hours.
The evidences in its favor rapidly accumulated, so that in eighteen months I used it with a feeling of almost certainty for this purpose.
Whilst it exerts the same influence on all persons, and at all ages, the true pathological condition being determined, it is especially valuable in treating diseases of children. In the young, the immature nervous centers suffer more severely, and we find the opposite conditions, of irritation with determination of blood, and atony with congestion.
The symptoms calling for the use of Belladonna are usually very plain: the patient is dull and stupid—and the child drowsy, and sleeps with its eyes partly open; the countenance expressionless; the eyes are dull, and the pupils dilated, or immobile; whilst, as it continues, respiration becomes affected, and the blood imperfectly aerated.
In these cases I prescribe Belladonna: in the adult, in the proportion of gtts. x. to gtts. xx., to Water ℥iv.; in the child gtts. v. to ℥iv.; in each a teaspoonful every hour. As these are mostly febrile cases, or at least have a feeble, frequent circulation as an element, I give Aconite in the usual doses.
Belladonna is also a specific in incontinence of urine. Not that it will cure any case, but those in which an enfeeblement of the pelvic circulation is the principal cause. Probably a lesion of the spinal cord has also much to do with it. Of course, it gives no relief where the incontinence arises from vesical irritation. The dose in. this case will be the same as above named, but only repeated four times a day.
Belladonna is also a specific in diabetes insipidus; even a Belladonna plaster across the loins being sufficient in many cases for its arrest.
Belladonna is undoubtedly a prophylactic against scarlatina, as I have thoroughly proven in my practice. Recollect, however, that it is only prophylactic in small doses; in doses sufficient to produce dilatation of the pupil, it has no such influence.
Belladonna has other special uses, but they may be briefly summed up: if in any case there is an enfeebled circulation, with stasis of blood, Belladonna is the remedy. Of course, acting upon some parts more directly than others, its influence will be more decided, but there is no case, with condition as above, in which it will not be beneficial.
I may say in conclusion, that we want a good preparation of the recent herb; and then it must be used in small doses to obtain the influences named. The doses given are the maximum. As we have had occasion to say before, the druggists care little about the quality of medicines sold; they are simply articles of merchandise, and there is little, if any, professional esprit with them, to aid us in baying them good. Therefore every physician must be on his guard when purchasing, and had better buy of first hands, and of those of proven honesty.