Veratrum Viride. (Veratrum.)
Preparation.—Prepare a tincture from the recent root, not fully dried, ℥viij. to Alcohol 76° Oj. Dose from the fraction of a drop to three drops. Veratrum from Western New York furnishes an excellent remedy, as is that from North Carolina and Northern Georgia. Specimens I have seen from the Western States were worthless. The root should be dug in August or September, freed from dirt, and dried sufficiently to permit of shipment to the place of manufacture. Now, it should be immediately crushed, and the year's supply of tincture prepared.
As commonly prepared for the drug trade, (Norwood's excepted), it is made of the dried root kept in stock from year to year, and possesses very feeble, if any medical properties. In this case, as with some other remedies, the process of drying destroys that finer medical action upon which we depend to influence the sympathetic nervous system.
We employ the Veratrum to lessen the frequency of the heart's action. When properly used it not only lessens the frequency of the pulse, but it removes obstruction to the free circulation of the blood, and thus gives slowness, regularity, freedom, and an equal circulation in all parts of the body. This action we call arterial sedation, though the name is not a good one.
To obtain this action it is necessary that the remedy be used in small doses, frequently repeated, and that sufficient time be given to accomplish the object without disturbing function or producing depression.
Veratrum is sedative in large doses, and its influence upon the heart may be speedily obtained in this way. But in this case its influence is depressing. It evidently causes slowness of the pulse by paralyzing the cardiac nerves. If the influence is continued there is impairment of the circulation, with tendency to congestion. As a general rule, the influence of large doses can not be maintained; either the remedy produces irritation of the stomach, so that it will no longer be tolerated, or its depressing influence upon the circulation becomes so great that it must be suspended.
In small doses the Veratrum is a stimulant to all the vegetative processes. Acting through the sympathetic or ganglionic system of nerves, it removes obstruction to the capillary circulation, gives tone to the vascular system, and strength to the heart. As the obstacles to a free circulation are removed, and the vessels through which the blood is distributed and returned, regain their normal condition, there is less necessity for increased action upon the part of the heart; and as the power of the heart is increased, there is less necessity for frequent contraction.
I give this as a theory of the action of Veratrum, but whether true or not, there is no question with regard to the facts as above stated.
Veratrum is the remedy for sthenia, where there is a frequent but free circulation. It is also the remedy where there is an active capillary circulation, both in fever and inflammation. A full and bounding pulse, a full and hard pulse, and a corded or wiry pulse, if associated with inflammation of serous tissues, call for this remedy.
As was remarked when describing Aconite, the Veratrum exerts a similar influence in acute inflammation, and directly controls the inflammatory process in its first stages. As a rule, the remedies that will cure fever will cure inflammation. To this I believe there are no exceptions, if a proper diagnosis is made, and we are governed by the same indication s for prescribing. Aconite, Veratrum, Gelseminum, Belladonna, Nux Vomica, Quinia, and other direct remedies, may be prescribed with the same certainty in inflammation as in fever. There is the same necessity for securing a good condition of stomach and upper intestine for digestion, and giving proper food. The same necessity for securing normal waste and excretion, and having the tissues renewed from good blood. The pallid tongue calls for alkalies, the dark redness of mucous membranes for acids, the pasty white coat for the sulphites, etc.
My experience teaches me that local inflammations are reached directly by this direct medication, and with a certainty a hundred times greater than by the old routine of internal and external counterirritation. It makes no difference where its location, how great or how little, the treatment is exactly the same as for a fever presenting the same symptoms or indications for remedies.
It must not be expected that the indications for remedies will be as pronounced in the case of inflammation as in fever, but they are always sufficient.
I have treated inflammation of the lungs with Veratrum alone, Veratrum with Gelseminum, Veratrum with Ipecac, Ipecac alone, Aconite alone, with a success I never saw obtained from the use of nauseants and counter-irritation. Other cases required the use of the Sulphites, of Quinia, or the mineral acids. I am not alone in this experience, for scores of our more recent students, who have learned this practice in lectures, give testimony to its success.
The local application of Veratrum, in the early stages of a superficial inflammation, will not unfrequently arrest its progress. In this way we use it in erysipelas, in phlegmous inflammation of cellular tissue, in felons, diseases of the bones, tonsilitis, etc.
We employ Veratrum in the treatment of chronic disease for its stimulant influence upon the vegetative processes. Properly used, we find that it lessens the frequency of the pulse, giving a free and uniform circulation; it lessens the temperature; it increases waste and excretion; and finally it stimulates digestion and nutrition.
My friend, Prof. Howe, regards it as one of the most direct and certain "Alteratives" in the Materia Medica, and in this opinion he is supported by a large number of practitioners. If the remedy has the action above named, we can readily see how it favorably influences chronic disease, and how frequently it may be employed with advantage.