AN INQUIRY 
INTO THE 
PHYSIOLOGICAL AND MEDICINAL PROPERTIES 
OF THE 
YEKATMM VIRIDE: 
TOGETHER WITH 
SOME PHYSIOLOGICAL AND CHEMICAL OBSERVATIONS 
CPON THE 
ALKALOID VERATRIA 
OBTAINED FROM THIS AND OTHER SPECIES. 
BEING THE 
PRIZE ESSAY TO WHICH THE AMERICAN MEDICAL ASSOCIATION 
AWARDED THE GOLD MEDAL FOR MDCCCLXIII. 
BY 
SAMUEL R. PERCY, M.D., 
PROFESSOR OF MATERIA .MEDICA AND IN THE NEW YORK MEDICAL COLLEGE. 
Salus populi suprema lex. 
REPRINTED FROM THE f HVj.. 
TRANSACTIONS OF THE AMERICAN MEDICAL ASSOCIATION 
PHILADELPHIA: 
COLLINS, PRINTER, 705 JAYNE STREET. 
1864. VERATRUM VI RIDE. AN INQUIRY 
INTO THE 
PHYSIOLOGICAL AND MEDICINAL PROPERTIES 
OF THE 
VERATRUM VIRIDE: 
TOGETHER WITH 
SOME PHYSIOLOGICAL AND CHEMICAL OBSERVATIONS 
UPON THE 
ALKALOID VERATRIA 
OBTAINED FROM THIS AND OTHER SPECIES. 
BEING THE 
PRIZE ESSAY TO WHICH THE AMERICAN MEDICAL ASSOCIATION 
AWARDED THE GOLD MEDAL EOR MDCCCLXIII. 
BY 
SAMUEL R. PERCY, M.D., 
PROFESSOR OF MATERIA MEDICA AND THERAPEUTICS IN THE NEW YORK MEDICAL COLLEGE. 
Salus populi suprema lex. 
REPRINTED PROM THE ' - f j / 
TRANSACTIONS OP THE AMERICAN MEDICAL ASSOCIATION. 
PHILADELPHIA: 
COLLINS, PRINTER, 705 JAYNE STREET. 
1864. “For the proper perfection of medicine as a natural science, two 
things are in main needed; the first is a right understanding of the 
causes and symptoms of disease ; the second, a correct knowledge of the 
action of medicines. Should our acquaintance with these two subjects be 
complete, we should then be able to do all that man could by any possi- 
bility effect, in the alleviation of human suffering. This sublime pro- 
blem is already being unravelled at one end. Diagnosis and Nosology 
are making rapid strides ; and perhaps we shall soon know what we have 
to cure. But at the other end our medical system is in a less satisfactory 
condition ; and though some impatient men have essayed, as it were, to 
cut the Gordian knot, and have declared boldly on subjects, of which 
they are ignorant, yet it must be confessed, that in the understanding of 
the action of medicines, and of their agency in the cure of diseases, we 
do not so much excel our ancestors. While other sciences are moving, 
and other inquiries progressing fast, this subject, so momentous in its 
applications, has, in spite of the earnest labors of a few talented 
investigators, made, after all, but little progress. Let but those who feel 
this want bestir themselves to remove it, and it will soon be done. Those 
doubts and difficulties, which are now slowly clearing away before the 
efforts of a few, will then be finally dispelled by the united energies of 
all; and instead of our present indecision and uncertainty on many 
points, we shall find ourselves eminently qualified to wage the conflict 
with disease, being skilled in that science whose name bespeaks its pecu- 
liar importance, the science of Therapeutics. ” 
Headland, Action of Medicines. CONTENTS. 
SECTION FIRST. 
NATURAL HISTORY OP VERATRUM VIRIDE. 
Page 
Botany and Physical Characteristics 7 
History 8 
SECTION SECOND. 
CHEMISTRY AND PHARMACY OF VERATRUM VIRIDE. 
Division First.—Chemical History 10 
Division Second.—Process for Obtaining the Tincture, Resinoid, and Alkaloid 
of Veratrum Viride 11 
Division Third.—Chemical Tests and Reagents for the detection of the Alka- 
loid, and its Comparison with Alkaloids obtained from other Species 
of Veratrum. ........... 13 
Division Fourth.—Dose and Mode of Administration 17 
♦ 
SECTION THIRD. 
PHYSIOLOGICAL ACTION ON ANIMALS. 
Division First.—Experiments elucidating the Physiological Action of Vera- 
trum Viride on Animals 19 
Division Second.—Experiments elucidating the Physiological Action of the 
Resinoid Principle of Veratrum Viride on Animals .... 27 
Division Third.—Experiments elucidating the Physiological Action of the 
Alkaloid Veratria obtained from Veratrum Viride and from other 
Species on Animals .......... 30 
Division Fourth.—Experiments elucidating the Physiological Action of 
Veratum Viride on Frogs and Bats, by the Examination of the Circu- 
lating Blood with the Microscope 33 
SECTION FOURTH. 
THERAPEUTIC APPLICATIONS. 
Division First.—Therapeutic Application of Veratrum Viride, with the rela- 
tion of a few Cases in point 38 6 
CONTENTS. 
Page 
Division Second.—Therapeutic Application of Veratrum Viride in Typhus 
and Typhoid Fevers 53 
In Phthisis, also, as a Means of Diagnosis in Diseases of the Lungs and Heart 55 
Division Third.—Therapeutic Application of the Resinoid of Veratrum 
Viride ............ 56 
Division Fourth.—General Synopsis of the Alkaloid Veratria, from Veratrum 
Viride ............ 59 
SECTION FIFTH. 
SUMMARY OP THE PHYSIOLOGICAL AND THERAPEUTIC ACTION OF VERATRUM 
VIRIDE ON MAN. 
Division First.—General Action 61 
Division Second.—Its Action on the Vascular System 64 
Division Third.—Its Action on the Respiratory System. .... 66 
Division Fourth.—Its Action on the Nervous System 67 
Division Fifth.—Its Action on the Muscular System 68 
Division Sixth.—Its Action on the Secerning System 68 
Division Seventh.—Its Action on the Alimentary Canal .... 70 
Division Eighth.—Emetic Action 70 
Division Ninth.—Recapitulation— 
First Degree of Operation . .72 
Second Degree of Operation 73 
Third Degree of Operation 73 
Fourth Degree of Operation .73 
Division Tenth.—Veratrum Viride in large and poisonous doses . . .75 
Division Eleventh.—Cumulative Action 77 
SECTION SIXTH. 
Modus Operandi 78 PRIZE ESSAY. 
PHYSIOLOGICAL AND MEDICINAL PROPERTIES 
OF THE YERATRUM YIRIDE. 
SECTION FIRST. 
BOTANY AND PHYSICAL CHARACTERISTICS OF VERATRUM 
YIRIDE. 
Nat. Ord.—Melantheceae. 
Linn. Syst.—Polyyamia Moncecia. 
Common Names.—American hellebore. Swamp hellebore. Indian poke. Itch 
weed, Spc. Spc. 
Part used in Medicine—The root. 
The Yeratrum Viride has a perennial, thick, fleshy root, “the 
upper portion of which is truncated, the lower solid, and beset 
with numerous whitish fibres or radicals.” “The stem is annual, 
round, solid, striated, pubescent, and from three to six feet high; 
being throughout the greater part of its length closely invested with 
the sheathing bases of the leaves. 
“ The leaves are alternate, and gradually increase in size as they 
descend ; the lower ones are from six to twelve inches long, oval, 
acuminate, pubescent, strongly ribbed, and plaited, the lower part 
of their edges meeting round the stem. The upper leaves are gra- 
dually narrower, the uppermost and the bracts, linear-lanceolate. 
“The flowers are numerous, yellowish-green, and arranged in 
compound racemes, axillary from the upper leaves, and terminal. 
Each flower is accompanied by a boat-shaped acuminate, downy 
bract, much longer than its pedicle. Peduncles roundish, downy. 
The perianth is divided into six oval, acute, nerved segments, of 
which the alternate ones are the longest, and all contracted at the 8 
prize essay: 
base into a sort of claw, with a thickened cartilaginous edge. The 
stamens are six, with recurved filaments and roundish. Anthers 
two-lobed. Ovaries three, cohering with acute recurved styles as 
long as the stamens. 
a The fruit consists of three capsules united together, and sepa- 
rating at top, and dehiscing on the inner side. 
“ Seeds flat, winged, imbricated.” 
It is indigenous in almost every part of the United States, grow- 
ing in wet meadows and upon the banks of rivers. 
“In this connection it may perhaps be asked, What are the botani- 
cal differences between Yeratrum viride and Yeratrum album? 
“To this inquiry, I must answer, that all which I have ever been 
able to discover consists in the fact that the edges of the segments 
of the perigone, in Yeratrum viride, are slightly incrassated, and 
contracted below their middle, which is not the fact in Yeratrum 
album; and that the general aspect of Yeratrum viride is coarser 
and rougher, and it is of a darker green color. These are small 
characters, but they appear to be permanent, incapable of change 
by climate, soil, culture, &c. &c.’n 
The root is the part used in medicine, and it should be gathered 
in the autumn after the top has died. It might probably be 
equally active in its medicinal effects if gathered very early in the 
spring, but this can seldom be done, for it commences to grow 
before the snow and frost have fairly disappeared. 
When freshly gathered the root has a strong, pungent, acrimo- 
nious taste, and when bitten, leaves a prickling and bitter taste 
in the mouth; but it loses most of this acrimonious effect by dry- 
ing. In order to preserve the root properly, it should be cut in 
fragments, well dried at a low temperature, and kept in a dry place, 
for if kept where it is damp it deteriorates very quickly. 
The leaves possess but little of the active properties of the root. 
History.—It was known and used by the Indian before the occu- 
pation of this country by the European. The best description of 
its early history, since that time, is given in Bigelow’s American 
Medical Botany, though neither Bigelow nor Ware understood its 
therapeutic powers in acute diseases, but, like the ancient Asclaspi- 
adee, with their preparations of “ white hellebore,” used it ouly in 
chronic affections. 
1 Tully’s Materia Medica, vol. i. p. 215. PROPERTIES OF VERATRUM VIRIDE. 
9 
About the year 1830, Drs. Tully and Ives, of New Haven, in- 
vestigated very fully the therapeutic properties of the plant. 
The attention of the medical profession was particularly called to 
its use in the treatment of acute diseases, by Dr. Charles Osgood, 
of Providence, R. I., in an essay written for the American Journal 
of Medical Sciences, 1885. 
Dr. Osgood, in a very modest manner, gives his preceptor, Pro- 
fessor William Tully, the credit of first calling his attention to its 
proper therapeutic powers, but Dr. Osgood, like modest men in 
general, underrates his own merits, and has written a very truth- 
ful and praiseworthy essay, which has been studied by all who 
have followed in his footsteps, but has been excelled by none; it 
still stands unrivalled, the best monograph that has been written 
on the plant. 
The writer of this “ Inquiry ” first learned the knowledge of the 
physiological and therapeutic properties of the plant from Dr. 
Osgood, in 1849, and he has constantly used it since that time. 
By the majority of the profession, but little attention was paid 
to Dr. Osgood’s essay, until the use of the plant was revived by 
Dr. Wm. C. Norwood, of Cokesbury, South Carolina. 
Dr. Norwood published a pamphlet on the therapeutic properties 
of Yeratrum viride in 1851, and disseminated it very widely; it 
has gone through three editions. 
After this time the properties of the drug were discussed in many 
of the medical societies of this country, and many excellent articles 
have appeared from time to time, in the medical journals, especially 
in those of the South and West. 
In 1856, the Section of Materia Medica of the New York Aca- 
demy of Medicine, appointed the author of this work to prepare a 
monograph upon the plant, and open a discussion upon its pro- 
perties in the Academy. 
In the same year the Harveian Circle, of the city of New York, 
appointed Drs. Percy, Miller, and Belden to perform a similar duty 
for that Society. 
In 1858, the Massachusetts Medical Society appointed Drs. Cut- 
ter, Richard, and Ingalls, a committee to bring this remedial agent 
to the direct attention of the Society, a task which they performed 
in May, 1858, and again in 1861. In the meantime many able 
papers appeared upon the uses of the plant, in the medical journals, 
among the best of which may be mentioned those of Professor 
M’Gugin, of the Iowa University. 10 
PRIZE ESSAY: 
SECTION SECOND. 
CHEMISTRY AND PHARMACY OF VERATRUM VIRIDE. 
DIVISION FIRST. 
CHEMICAL HISTORY. 
Dr. Charles Osgood, of Providence, R. I., published the results 
of some chemical experiments upon this plant in the American 
Journal of Pharmacy, vol. i., second series. He obtained a white, 
inodorous, and very acrid powder, which he thought to be the 
alkaloid principle of the plant, but no satisfactory experiments 
were made by him on the point. 
In the 9th volume of the same journal, Thos. A. Mitchell gives 
a proximate analysis of the plant, and states that he obtained an 
active principle, in the form of a white powder, but he was unable 
to make any chemical examinations, as the amount obtained was 
very small. 
In the 10th volume of the same journal, Henry W. Worthing- 
ton gives a more complete analysis of the plant, and states that he 
obtained “ an alkaloid substance identical with veratria,” that it 
“was soluble in dilute acids,” and that “the sulphate, tartrate, and 
oxalate were crystallizable salts.” 
To Mr. Worthington, then, is due the honor of having first 
announced by publication, and demonstrated by chemical tests 
that an alkaloid existed in the plant. 
In the same journal for May, 1857, Mr. Joseph G. Richardson 
gives an elaborate chemical essay on this plant. After reviewing 
what was already known and giving the results of various experi- 
ments for obtaining the alkaloids, Mr. Richardson gives several 
tests for its detection, and also proves by many separate analyses 
that the alkaloid obtained by him was identical in its chemical 
reactions with the alkaloid obtained from Veratrum album. 
In 1857 the author of this monograph presented for the inspec- 
tion of the Fellows of the N. Y. Academy of Medicine, 88 grains PROPERTIES OF VERATRUM VIRIDE. 
11 
of the pure alkaloid obtained from Veratrum viride, and described 
the process by which it was obtained; this was in a very fine, 
white, amorphous powder, possessing all the physical properties 
of veratria. The Academy did not publish this analysis. 
In 1862 Geo. J. Scattergood made an elaborate investigation of 
the alkaloid obtained from both species, the results of which he 
presented in an essay to the American Pharmaceutical Association, 
at their meeting, August, 1862, and it may be found entire in their 
printed proceedings of that year. 
DIVISION SECOND. 
PROCESS FOR OBTAINING THE TINCTURE, RESINOID, AND ALKALOID. 
Tincture.—The root, coarsely powdered, is treated with alcohol 
fortius, sp. gr. 0.817, by percolation, the alcohol distilled off, and 
the residuum evaporated to an extract over a water bath until it 
is nearly dry, or until it ceases to become lighter upon being 
weighed at intervals of an hour or two. 
To make the concentrated tincture spoken of in this work, one 
part of this extract is dissolved in ten parts of alcohol, 0.817, and 
filtrated. 
Eesinoid.—Veratrum viride root coarsely powdered is treated 
with alcohol, 0.817, by percolation, the alcohol distilled off, and the 
residuum evaporated to a soft extract. A saturated solution of 
this extract is made in alcohol, 0.817, and filtered slowly into a 
large quantity of cold water previously acidulated with sulphuric 
acid, and kept constantly stirred. The fluid is filtered off, leaving 
most of the resinoid substance in the beaker; fresh acidulated water 
is added, well stirred, and the whole then thrown on the filter, and 
repeatedly washed with cold water, until every trace of sulphuric 
acid is removed; it is then dried. This substance I have called 
resinoid. By repeated examinations, it is entirely free from every 
trace of alkaloid. 
It is also free from the extractive substances that are soluble in 
water. 
I have used this in the form of tincture, made by dissolving it 
in alcohol 0.817, of the strength of grain of the resinoid to each 
minim. This resin is of a soft consistence ; about 25 per cent, of it 
is soluble in ether, and the remainder is harder and more friable. 12 
PRIZE ESSAY: 
Both resins produce the therapeutic action above noted, but the 
alcoholic resin is more uniform and certain in its action than the 
ethereal. The ether extracts the oily portions. 
Allmbid.—The processes adopted by Worthington, Richardson, 
and Scattergood may be found in the works already referred to. 
The process that I have adopted for obtaining the alkaloid has 
differed from that recommended by either of these gentlemen. 
Any quantity of the coarsely-powdered root of the Yeratrum 
viride is moistened with water and packed into a percolator; water 
acidulated with hydrochloric acid is added, sufficient to cover the 
root, and allowed to stand for twenty-four hours. 
It is then allowed to percolate, and the first portion of the fluid 
which contains most of the strength of the root, is kept by itself; 
fresh acidulated water is added, until the root is exhausted. 
The latter liquid is evaporated to about one-quarter its former 
bulk, filtered, and the first portion of the percolate mixed with it; 
soda is then added so long as a precipitate forms. 
The precipitate is washed in a small quantity of cold water and 
dried; it is then treated with ether, the ether is filtrated off, and 
allowed to evaporate. 
This mass is then treated with water acidulated with hydro- 
chloric acid, filtered, and ammonia added so long as a precipitate 
forms; the fluid is filtered off, the precipitate washed in a small 
quantity of cold water, and mixed with a small amount of animal 
charcoal, which has been previously moistened with a little 
alcohol. 
The whole is put into a flask and alcohol added to it; the flask 
is put in hot water, and the hot alcoholic solution filtered off, and 
more alcohol added, which is treated in the same way. 
The whole of the alcoholic solution is either distilled or evapor- 
ated, according to the quantity of alcohol used; and the soft mass 
that is left is treated with successive quantities of boiling water, 
acidulated with hydrochloric acid. 
This solution is filtered and the alkaloid is precipitated with 
ammonia. 
The precipitate when dry is treated with ether, filtered, and the 
ether allowed to evaporate slowly. 
The alkaloid is in a semi-crystalline state and of a slightly yel- 
low tinge. 
To prevent the excessive and painful sneezing caused by inhal- PROPERTIES OF VERATRUM VIRIDE. 
13 
ing this alkaloid, I have found it advisable, when manipulating 
with it, to anoint the nostrils as far up as possible with castor oil, 
and to tie over the nostrils a piece of moistened sponge. 
DIVISION THIRD. 
CHEMICAL TESTS AND REAGENTS FOR THE DETECTION OF THE 
ALKALOID. 
As I have obtained veratria from Veratrum viride, it is, if pre- 
cipitated, a pure, white, amorphous powder; if from the evapora- 
tion of ether, it is semi-crystalline and of a slightly yellow tinge. 
It is of an acrid and burning taste, but is not very bitter. It 
is necessary to be exceedingly cautious in handling it, for if a very 
minute portion is breathed up the nostrils, it excites violent sneez- 
ing, which is difficult to check, and occasionally produces alarming 
symptoms. 
Its formula is probably the same as that of commercial veratria, 
C34H22N06Ve. 
If a small quantity of veratria be placed upon platina and held 
over a flame, it fuses at a gentle heat; if it be now removed it soli- 
difies as it cools, and becomes a semi-transparent yellow mass; but, 
if the heat be continued, it swells up and is gradually dissipated. 
It is insoluble in water, but readily soluble in ether, alcohol, chlo- 
roform, and benzole. 
It neutralizes acids, and forms salts which are soluble in water; 
they are of an acrid and persistently burning taste, and produce a 
considerable degree of irritation if rubbed upon the skin. 
In the experiments I give below I have as closely as possible 
followed the experiments performed by my friend, Professor T. G. 
Wormley, upon the purified veratria (of Murk’s manufacture) from 
Veratrum sabadilla, and published by him in the Ohio Medical and 
Surgical Journal, July, 1860. 
My object was to institute a more elaborate research than that 
previously made by Mr. Richardson, and ascertain if the alkaloids 
from the different plants were identical in their chemical reactions. 
For the purpose of experimenting, a given quantity of the al- 
kaloid was dissolved in a given quantity of distilled water, with pre- 
cisely sufficient hydrochloric acid to effect its solution. 14 
PKIZE ESSAY: 
1. Potassa.—Potassa produces in solution of hydrochlorate of 
veratria a copious, flocculent, dirty-white precipitate, which is not 
soluble in an excess of the reagent. If viewed immediately on 
precipitation by a low power of the microscope, it is seen in co- 
agula, but if viewed after standing some minutes many short pris- 
matic crystals will be seen amongst the coagula, which shortly dis- 
appear. The grain of this veratria is most readily detected by 
this reagent, and with the microscope yoVxr may be easily recog- 
nized. The carbonate of the alkalies acts in the same manner as 
potassa. 
2. Ammonia.—The reaction is the same as with potassa, but the 
precipitate is slightly soluble in an excess. 
3. Nitric Acid.—If concentrated nitric acid is brought into contact 
with this alkaloid it agglutinates into resinous-looking lumps of a 
dirty yellow color, which slowly dissolve in the acid. If the alka- 
loid is first moistened with water and a small quantity of nitric 
acid then applied, it exhibits a yellow tint, but on the addition of 
water forms a colorless solution. 
4. Sulpliocyanide of Potassium.—A flocculent white precipitate 
insoluble in excess of the reagent. 
5. Chromate of Potassa.—A light yellow amorphous precipitate, 
insoluble in an excess. 
6. Bi- Chromate of Potassa.—A copious, dirty yellow amorphous 
precipitate, insoluble in an excess of the reagent, but soluble in 
nitric acid. 
7. Ferrocyanide of Potassium.—A copious bluish-black, flocculent 
precipitate, soluble if a small excess of the reagent is carefully 
added.1 
8. Ferricyanide of Potassium.—An abundant greenish-yellow pre- 
cipitate, soluble in an excess. 
9. Iodide of Potassium.—A dirty white amorphous precipitate, 
becoming a dirty greenish-white upon standing some time. 
10. Iodine in Iodide of Potassium.—A copious reddish-brown 
amorphous precipitate, soluble in liquor potassee. 
11. Bromine in Bromo-hydric Acid.—A dull yellow amorphous 
precipitate. 
12. Carhazotic Acid.—A greenish amorphous precipitate, which 
upon standing a short time becomes a greenish-yellow. 
1 “ This reaction takes place if an old solution is used, hut if a new and pure 
solution is used there is no precipitate.”—W. PROPERTIES OF VERATRUM VIRIDE. 
15 
18. Bi- Chloride of Platinum.—A dirty yellow amorphous preci- 
pitate. 
14. Bi-Chloride of Mercury.—A white precipitate. 
15. Tannic Acid.—A dirty white amorphous precipitate. 
16. Terchloride of Gold.—A canary yellow amorphous precipi- 
tate, insoluble in an excess of the reagent, and insoluble in acetic 
acid, except upon the application of heat. 
17. Sulphuric Acid.—This test should always be applied to the 
alkaloid or its salts in a dry state. If a small portion of the alka- 
loid is touched with a drop of strong sulphuric acid no color is 
immediately developed, but in the course of a minute a yellowish- 
red, and then a beautiful bright red color appears. This color will 
appear immediately upon touching the veratria with the sulphuric 
acid if the slide upon which it is placed is warmed. The color is 
not destroyed by heat, but it disappears after standing two or three 
hours; the color will disappear in fifteen minutes if a small crystal 
of bi-chromate of potash is stirred upon the mixture. 
Professor Wormley has, by this reagent, detected of a 
grain of purified commercial veratria. 
This last reagent—sulphuric acid—is the only one of all these 
that can be deemed decisively confirmatory of the presence of 
veratria; the other reagents are common to so many organic sub- 
stances that they can only be regarded as confirmatory in connec- 
tion with the action of sulphuric acid. 
There is but one substance with which it would be at all likely 
to be confounded by this reaction of sulphuric acid, and that sub- 
stance is salicine. Sulphuric acid produces a red color on solanine, 
narceine, papaverine, and piperine, but, as with salicine, the color 
is produced immediately upon the contact of the cold acid. 
But the reaction of sulphuric acid on salicine and veratria differ, 
for whereas on salicine the color is immediately produced upon the 
application of sulphuric acid on a cold slide, we have seen that 
the color does not appear for a minute or more with veratria un- 
less the slide or the acid is warmed. 
The color produced is also different, for with veratria it is, for a 
moment, a yellowish, then a beautiful bright red, then an intense 
blood-red color; with salicine it is more of a purple red. There 
is the difference between the two colors that there is between bright 
arterial and venous blood. The color produced upon veratria lasts 16 
pkize essay: 
but two or three hours, while that produced upon salicine lasts 
double that time. 
But the behavior with other reagents would definitely settle the 
point if doubts were excited. 
In a correspondence with Geo. J. Scattergood, of Philadelphia, 
on this subject, he says: “ By treating commercial veratria with 
ether I have separated it into two substances. That portion in- 
soluble in ether behaves with sol. of iodohydrarg. potass., and with 
tr. iodine, on a muriate boiling, and sal ammonia added while yet 
warm, differently from the way pure veratria does. 
“ Yeratria, soluble in ether, gives a beautiful pink-red or crim- 
son color with sulphuric acid, and a butyric acid smell; the matter 
insoluble in ether gives a darker color, a greenish or brownish-red, 
and a musky odor.” 
It will thus be seen that in following the experiments of Prof. 
Wormley with veratria obtained from Yeratrum sabadilla, we have 
obtained almost identical results with the veratria we have made 
from Yeratrum viride; and have thus confirmed Mr. Richardson’s 
observations, that the two alkaloids were identical in their chemi- 
cal reactions. 
Note.—“ Extraction of Veratrine by Ether and Chloroform. 
“ 1. The chloride of veratrine. One grain pure veratrine dissolved in 100 grains 
of water by the aid of hydrochloric acid, and then the solution agitated for seve- 
ral minutes with an equal volume of ether; the ether then drawn oif and evapo- 
rated to dryness, leaves a residue of 3-100th grain of chloride of veratrine. 
“ One grain of veratrine in 100 grains water, by the aid of hydrochloric acid, and 
agitated with an equal volume of chloroform, and the chloroform evaporated to 
dryness, leaves an opaque vitreous residue of 33-100th grains of chloride of vera- 
trine. 
“ 2. Pure veratrine. One grain of veratrine dissolved by hydrochloric acid in 
100 grains of water, and the solution rendered slightly alkaline by potash solu- 
tion, gives a copious white precipitate, so dense as to make the liquid almost gela- 
tinous. If now the mixture be mixed with an equal volume of ether and agitated 
for several minutes, and then the ethereal solution evaporated to dryness, it leaves 
a transparent vitreous residue of 91-100th grain of pure veratrine. 
“ When one grain of veratrine is treated as above and agitated with an equal 
volume of chloroform, and the chloroform solution evaporated to dryness, it leaves 
a perfectly transparent vitreous residue of 97-100th grain of pure veratrine.”— 
From Ohio Med. and Surg. Journal, vol. xii., No. 6, p. 464, by Prof. Wormley. PROPERTIES OF VERATRUM YIRIDE. 
17 
DIVISION FOURTH. 
DOSE AND MODE OF ADMINISTRATION. 
By consulting other parts of this monograph it will be seen that 
the dose of the concentrated tincture (the formula for which is 
given in the first division of this section) varies in quantity and 
frequency of repetition according to the effect desired to be pro- 
duced. 
I shall be exceedingly explicit upon this point throughout the 
whole of the fifth section, and shall, therefore, need but few words 
at this place. 
As an arterial sedative the dose, to an adult, usually be 
from 2 to 3 minims, repeated every one, two, or three hours, ac- 
cording to the effect upon the pulse. 
If it be deemed advisable to bring the patient promptly under 
its influence 3 minims may be given every hour until the pulse in- 
dicates its sedative influence, which will generally be felt before 
the third hour ; it may then be repeated either in smaller doses or 
at longer intervals, but it will produce less unpleasant effects in 
small doses frequently administered, than in large ones at longer 
intervals. 
Large doses are apt to produce vomiting, paleness, and alarming 
prostration, and the physician is frequently called in haste in con- 
sequence of the unpleasant effects of them. Nearly all instances 
of alarm have been produced by large doses, and not by small ones 
frequently repeated. Large doses, also, do not so readily control 
the circulation, as excitement and vomiting supervene, and the 
pulse sometimes becomes thready, frequent, and irregular. 
With children it is especially necessary to give it in small and 
frequent doses rather than in large ones at long intervals, and if 
administered in this manner alarming effects will seldom be pro- 
duced. 
Children, from the activity of the circulation and rapidity of 
excretion, will bear a rather larger proportional dose than adults ; 
thus a child eight years of age will bear about one-half the dose an 
adult will. To a child of that age 2 minims may be given as a first 
dose, and one minim may be repeated afterward every one or two 
hours according to its effect upon the pulse. Unless in very urgent 18 
prize essay: 
cases it is not advisable to bring the pulse more than 10 or 15 
beats below the normal standard, and to do this it is but required 
to increase or diminish the dose according to the state of the pulse, 
and give it at intervals of one or two hours rather than at longer 
periods. 
With adults a given number of minims may be put into a given 
number of teaspoonfuls of water, and one or more teaspoonfuls 
given at a dose. 
With children it is more easily given in sweetened water, or 
sweetened water and orange juice, or syrup of tolu. PROPERTIES OF YERATRUM VIRIDE. 
19 
SECTION THIRD. 
PHYSIOLOGICAL ACTION ON ANIMALS. 
DIVISION FIRST. 
EXPERIMENTS ELUCIDATING THE PHYSIOLOGICAL ACTION OP 
YERATRUM VIRIDE ON ANIMALS. 
Experiment I.—Ten drops of the concentrated tincture put into 
a gelatine capsule, were passed down the throat of a mongrel dog 
weighing about twenty pounds; the dog had eaten nothing for six 
hours, and the pulse was beating 90 in the minute. In an hour 
and ten minutes after taking it, the dog vomited freely, and twice 
afterwards. In an hour and a half after the dose was given, the 
pulse was 60; in two hours and a half, 53. In four hours it had 
risen to 56; the dog seemed well, and ate heartily. 
Experiment II.—Twenty drops of the same tincture were given 
to a dog who had been fasting for twelve hours. In an hour and 
seventeen minutes he vomited, and continued to strain and vomit 
for some time. At the expiration of two hours and a half, the same 
dose was repeated, the pulse then beating 61 in the minute. The 
dog, exhausted by the previous vomiting, lay down and did not 
attempt to stand up. In four hours from the administration of the 
first dose, the pulse was 29 in the minute, and the dose was again 
repeated. The retching was frequent, but nothing but a small 
quantity of viscid mucus and bile was thrown up. In five hours 
from the administration of the first dose, the pulse was 21, soft, 
creeping, and easily compressible. The pupils were fixed, but of 
ordinary size. They did not contract in strong light, but the lids 
were closed if anything was pointed at the eye. The dog would 
not move when struck with a switch. Six hours from the first 
dose, the twenty drops were repeated, the pulse being then 18, and 
intermittent. At the seventh hour there was great prostration, 
the retching continued, the pulse was irregular, intermittent, and 
easily compressed, and beating 17 in the minute. The dog would 20 
PRIZE essay: 
remain in almost any recumbent position he was placed, and his 
limbs were moved without an attempt at resistance. The lids 
would close if the eyeball was touched, otherwise they remained 
open; the eye had a fixed, staring, lack lustre look. 
The dog was then left, and I did not see him again for twelve 
hours, during which time he drank two quarts of water. He 
seemed very feeble, and would come upon being called. The 
pulse was 149 and soft. He ate freely of meat, and later in the 
day seemed well, but sober, the pulse not exceeding 83 after his 
meal. 
Experiment III.—Two drachms of the same tincture in capsules, 
were enveloped in meat and given to a small dog. The pulse was 
87. In two hours and twenty minutes he vomited some milk that 
had been taken just before the medicine, and threw off finally, all 
the contents of the stomach. In three hours the pulse was 89. 
After twenty-four hours, during which he was fed, he seemed quite 
well and lively. 
Experiment IY.—The same dose was given in the same manner 
to a dog, and immediately afterwards a pint of melted lard was 
thrown into the stomach with a syringe. The pulse was 92. In 
three hours and five minutes the dog vomited, and the retching 
was prolonged and prostrating. In six hours the pulse was 44, and 
the prostration very great. 
Experiment Y.—An ounce of the tincture, evaporated down to 
a soft extract and enveloped in a thin slice of meat, was given to a 
small dog who had eaten nothing for twenty-four hours. The 
pulse was 97, sharp and irritable. In thirty-eight minutes he 
vomited the meat with some fluid and mucus, and some of the 
extract. The pulse had fallen to 78. The vomiting continued, 
bringing up some frothy and bilious-looking matter. In two hours 
and a half the pulse was 55, and it did not at any time fall below 
48. The prostration was less than in the two previous experi- 
ments. No doubt the greater part of the extract had been thrown 
up. 
Experiment YI.—Twenty minims of the same tincture were 
passed by one of Wade and Ford’s hypodermic syringes, into the 
femoral artery of a dog, whose pulse was at 85. In one minute he 
fell upon his side quite powerless, the eyes became dull and fixed, 
and the lids did not close on touching the cornea. In five minutes 
every sign of life was extinct. 
Autopsy immediate. The heart’s action had ceased; but upon PROPERTIES OF VERATRUM VIRIDE. 
21 
making an opening into the aorta, a large quantity of blood was 
thrown out, and the heart’s contractions were renewed feebly for 
several seconds. Both right and left heart were filled with blood. 
The blood coagulated. 
Experiment VII.:—Into the cellular tissue of the right lumbar 
region of a mongrel dog weighing sixteen pounds was passed, by 
Wade and Ford’s hypodermic syringe, ten minims of the concen- 
trated tincture. The pulse at the time was 110. The movements 
soon became uneasy and unsteady. In eighteen minutes the dog 
vomited, and the pulse was reduced to 63. In thirty-four minutes 
the dog staggered, lay down, and was unable to rise, the retching 
continuing frequent. In thirty minutes the dog lay completely 
on its side, and the saliva flowed very freely from his mouth. The 
eye was dull, the pupils widely dilated, but fixed; but the eye 
closed if the cornea was touched. The limbs were very flaccid, the 
pulse 32. Ten minims more of the same tincture were now in- 
jected into the left lumbar region. In forty-five minutes from the 
first injection, the heart was beating 14 in the minute, and very 
irregular; the saliva continued to flow freely from the mouth, 
being almost as limpid as water. The dog was perfectly insensible to 
pain. The respirations were slow but full. At one hour from the 
first injection, the heart merely fluttered; the dog could be moved 
in any way without the slightest voluntary motion. The urine and 
feces were passed involuntarily. I now threw into the stomach, 
with a syringe, a pint of warm milk punch, containing four ounces 
of brandy, and ten grains of carbonate of ammonia. In ten 
minutes the pulsations, though irregular, could be felt distinctly, 
in eighteen minutes the heart was beating regularly 30 in the 
minute, and in two hours the dog was walking about, but with a 
very demure and sober appearance. The pulse was then 55. The 
next day he had quite recovered. 
This dog was peculiarly susceptible to the influence of the medi- 
cine. I have repeated the same experiment on other dogs, but 
with nothing like the same amount of prostration resulting. 
Experiment YIII.—Ten minims of the tincture were injected 
into the cellular tissue of the hind leg of a rat. In eleven minutes 
I took him out of the cage, and he suffered himself to be handled 
without making any resistance. On replacing him in the cage, he 
would remain in any position in which he was laid, without mov- 
ing. The next day he was running about apparently as well as 
ever. 22 
prize essay: 
Experiment IX.—To a large, coarse mongrel dog was adminis- 
tered, by injection into the stomach, one ounce of the tincture, in 
about eight ounces of good beef soup. The pulse was 142. For 
about fifteen minutes he seemed quite well, but soon after showed 
signs of uneasiness, walking about with a dejected air, and con- 
stantly lying down and rising again. In forty seven minutes he 
vomited violently, throwing off the contents of the stomach with 
great force. This continued for some time. At one hour from 
administration, the pulse was 63, at two hours, 40. Two drachms 
more of the tincture were then administered. In about fifteen 
minutes the vomiting was again excessive. In three hours from 
the first administration he lay still and quiet on his side; the pulse 
was 34, the pupils were fixed and without expression. The saliva 
flowed very freely, and was saved for future experiment. In four 
hours from the first administration I injected, by the hypodermic 
syringe, twenty minims of the tincture into the femoral artery. In 
a minute and a half he was dead. 
Autopsy immediate. The bladder contained two and a half 
ounces of urine, which was saved. The chambers of the heart on 
each side were filled with fluid blood. The lungs were congested, 
while the mucous membrane of the stomach was but very slightly so. 
Experiment X.—This urine, diluted with about the same quan- 
tity of water, was thrown into the stomach of a cur weighing seven 
pounds. The pulse was 144. In an hour and thirty-five minutes 
the dog vomited a small quantity of frothy mucus. The pulse was 
then 97. At two and a half hours it was 83, and at three hours, 73. 
Experiment XI.—At the same time with the last experiment, 
the saliva was administered to another cur of the same size. This 
saliva measured eight fluidrachms. The pulse was then 127. In 
one hour and thirty-five minutes the pulse was 82. At two and 
a half hours, 70; at three hours, 59. This dog did not vomit. 
Experiment XII.—To a small cur dog, when the pulse was 140, 
I administered, in a piece of meat rolled up, fifteen minims of the 
tincture, with one-quarter grain sulphate of morphia. In one hour 
the dog was very still and quiet, the pulse 112, and the respira- 
tions easy and full. I repeated a five minim dose of tincture of 
veratrum combined with one-eighth grain of sulphate of morphia 
every hour for five hours. In six hours there had been no 
vomiting, the pulse was 45, and the respirations slow, less frequent 
than without the morphia. The pupils were contracted. The 
morphia here overpowered the veratrum. At the expiration of ten PROPERTIES OF VERATRUM VIRIDE. 
23 
hours there had been no vomiting; the pulse was 46. The effects 
of the morphia still continued, and the dog was roused with diffi- 
culty. 
Experiment XIII.—Two drachms of the tincture were thrown 
into the stomach of a cur dog weighing about nine pounds. In 
forty-eight minutes the vomiting was very free. I now injected 
into the cellular tissue, under the fore leg, one-quarter grain of 
sulphate of morphia in solution. In a few minutes the vomiting 
ceased, and the dog lay down and slept for several hours. In 
three hours the pulse was reduced to 100 beats in the minute. 
The pupils were contracted. I have repeatedly administered codea 
in doses three times larger than morphia, but without as marked 
beneficial results. 
Experiment XIY.—Five minims of the tincture were injected 
into the cellular tissue, around the left eye of a cur dog. The 
pupils were watched for three hours, but there was no appreciable 
difference between them, both were dilated. 
Experiment XY.—To a strong, coarse cur was administered 
gr. of the acetate of strychnia; the pulse was 129. In five min- 
utes the pulse had increased to 167, irritable and wiry. Two drachms 
of the tincture of veratrum viride were now thrown into the sto- 
mach. There were frequent and violent twitchings of the muscles, 
more particularly in the lumbar region and hind legs. In half an 
hour the pulse was 160. The pulse continued gradually to fall, and 
the convulsive actions to grow less, until at 2 hours and 17 min- 
utes he vomited. From this time there were no more twitchings, 
and in four hours the pulse had fallen to 83. 
Experiment XYI.—To a strong coarse cur, weighing about 25 
pounds, was given \ gr. of strychnia. He had had nothing to eat 
or drink for 24 hours. The pulse was 131. In fifteen minutes he 
was violently convulsed; the pulse could not be counted. I now 
injected into the cellular tissue over the cardiac region, one drachm 
of the concentrated tincture of veratrum viride. In 30 minutes 
after, he vomited, and the pulse could be counted, being 126. The 
convulsive movements grew less and less violent, and in one hour 
and thirty minutes had ceased. The prostration was not great, 
and the pulse did not sink below 100. 
Experiment XYII.—The same dog, by means of the veratrum 
viride, was brought into the condition described in Experiment II. 
When perfectly prostrate and unable to make the slightest resist- 
ance, l gr. of the acetate of strychnia was thrown into the sto- 24 
PRIZE ESSAY: 
mach; the pulse was then only 17 in the minute. In 16 minutes, he 
gave one strong convulsive movement, and stood upon his feet, 
with an alarmed and wild appearance; the pulse had risen to 46. 
He lay down again, and did not attempt to move for two hours; 
the pulse was 84. Late the next evening I gave this dog 1J gr. 
of the same strychnia, without being accompanied or followed by 
veratrum ; in the morning he was dead and very stiff. See Expt. 
No. IY., p. 247. 
These experiments with strychnia have been repeated many times, 
but great caution is necessary, for an overdose of strychnia quickly 
causes death. Veratrum is only antidotal to a certain point. 
Experiment XYIII.—To a cur dog, weighing about 12 lbs., the 
tincture was administered in repeated doses, as in Experiment II., 
until the pulse was reduced to 26 beats in the minute. The electro- 
magnetic apparatus was then applied, one pole being placed under 
the fore leg of the left side (where there was very little hair), be- 
tween it and the body, and the other pole in the same position on 
the hind leg of the opposite side. The convulsive twitchings pro- 
duced by this were for some time quite feeble, but by continuing 
the current they became stronger, and in 15 minutes the pulse had 
increased to 32 beats. Upon suspending the application of the in- 
strument, the pulse again fell to 26, but five minutes after its re- 
application the dog had to be held, to restrain its struggles. After 
continuing for five minutes more he was able to stand, and in ten 
minutes more he walked about. The pulse had risen to 56. 
Experiment XIX.—Two dogs of about equal size were brought 
into nearly the same condition as described in Experiment II., 
by the tincture of veratrum viride. One of them was kept in a 
warm room all night, and the other was put into an open yard. 
(This was in Jan. 1857, and the temperature about 24° F.) In the 
morning the dog confined in the room had nearly recovered, while 
the one exposed to the cold was dead and frozen. This experiment 
was performed to ascertain whether death would be caused while 
diminishing the temperature of the body. As the pulse was very 
slow, the animal heat was necessarily diminished, and when the dog 
was exposed to a temperature below freezing point,-it was not able, 
under the depressing influence of the medicine, to maintain its 
animal heat, and consequently it died from the effects of cold. 
This fact should teach us the necessity in cases of poisoning with 
this medicine, with other arterial sedatives, or in cases of profuse 
hemorrhage, of keeping the patients in a warm and comfortable PROPERTIES OF VERATRUM VIRIDE. 
25 
room; for if they are in a cold place their temperature may be dan- 
gerously diminished, whereas no great diminution of animal heat 
will be experienced if they are kept in a warm place. 
Experiment XX.—To a dog of about 16 lbs. weight the tinc- 
ture was administered, in repeated doses as in Experiment II., 
until the pulse was reduced to 31 beats in the minute. A teaspoon- 
ful of tincture of cantharides was then given in a little water; the 
vomiting and retching were quickly suppressed; in 7 minutes, the 
pulse had risen to 42—in 15 minutes it was 49 ; a teaspoonful dose 
of tincture of cantharides was then repeated. In half an hour from 
the administration of the first dose the pulse was 54, and the dog 
seemed in a great measure to have recovered from his depression. 
This same experiment was repeated seven times with this dog, with 
very similar results. The tincture of cantharides did not produce 
strangury, even when pushed to 3iv within the hour. 
To another dog it was administered three times, after the de- 
pressing effects of veratrum viride, in doses of 3ij twice repeated 
at an interval of 30 minutes, and it quickly relieved the depression 
and the sinking pulse, but produced a hard and frequent pulse, 
many beats quicker than when the experiment was commenced. 
There was also, with this dog, at each experiment, great thirst, 
but no strangury or purging; at the two last trials there was 
priapism. 
Experiment XXI.—To a large dog, weighing about 30 lbs., 3iss 
of tincture of cantharides was administered every 15 minutes until 
3ix were given. The pulse at the first dose was 93 in the minute; 
it gradually increased, becoming hard, wiry, and too rapid to count. 
In 2 hours and 40 minutes he had a bloody stool, evidently accom- 
panied by severe abdominal pains; the respiration was hurried; 
there was great thirst, and painful priapism. At the expiration 
of three hours from the administration of the cantharides, 3j of the 
tincture of veratrum viride was given. In 18 minutes the priap- 
ism had ceased, and apparently the abdominal pains also. In 30 
minutes the pulse could be counted, 114 in the minute. He now 
vomited once, throwing up a quantity of water; he then lay down, 
and did not move for two hours; the pulse was at that time 89. The 
next day he seemed quite well. 
Upon this dog this experiment was repeated four times, three 
times with somewhat similar results as above stated, the resinoid 
tincture being given. On the fourth trial, but little water was given 
him, and he died in convulsions before the veratrum viride could be 26 
PRIZE ESSAY: 
administered. The kidneys, bladder, and mucous membrane of the 
stomach and intestines were much congested. 
Of the different medicines I have administered, these two, vera- 
trum and cantharides, seem to me to be the most directly antidotal, 
and wherever I have found an inordinate degree of depression 
caused by any of the preparations of veratrum viride, I have ob- 
tained the quickest and most complete relief from these symptoms 
with cantharides. I have administered it twice with equally bene- 
ficial effects in the human subject. 
Experiment XXII.—A cur dog, troubled with hydrocele of the 
left testis, was brought to me. I withdrew the fluid by means of 
Wade & Ford’s hypodermic syringe, and injected into the cavity 
20 minims of concentrated tincture diluted with one drachm water. 
It was three hours after the operation before any effect was noticed 
upon the pulse, and its greatest diminution in five hours was only 20 
beats in the minute. The dog was kept, and in two weeks the cure 
of the hydrocele was complete. 
Experiment XXIII.—One fluidounce of blood was drawn from 
the femoral vein of a large cur dog into a graduated glass. Twenty 
minims of the tincture of veratrum viride was then administered 
by hypodermic injection, and in one hour after another ounce of 
blood was drawn in, as nearly as possible, the same manner into a 
similar graduated glass. Both were put aside, and in six hours it 
was almost impossible to tell them apart. 
Experiment XXIY.—A fluidounce of blood was drawn, under 
like circumstances, from a small cur dog. An ounce of the tinc- 
ture was then thrown into the stomach with a little water. In 
hour there was vomiting. The same quantity of blood was then 
drawn as before, and both were set aside until the next morning 
(7J hours). There was scarcely any difference in appearance. 
These experiments were performed in order to ascertain whether 
veratrum viride, like many of the salines and antimonials, dimin- 
ishes the amount of fibrin in the blood or causes any difference in 
appearance. The results would indicate that it does not. 
Experiment XXY.—A compress was applied to the femoral 
artery and a strong ligature tied very tightly around the right thigh 
of a small dog, the nerve having been dissected up and left out of 
the ligature. Two drachms of the tincture were thrown into the 
stomach, and as vomiting was induced, one drachm of the tincture 
was thrown into the opposite femoral artery. Death ensued imme- 
diately. About an hour after the death of the animal, the muscles PROPERTIES OF YERATRUM VIRIDE. 
27 
were laid bare in several places and but little effect was produced 
upon them by galvanism; but upon the right leg below the ligature 
galvanism produced active movements of the muscles, as in death 
from ordinary causes. 
This proves that the action upon the muscles is communicated 
through the blood and not through the nerves. 
This dog, before the application of the ligature, was fully under 
the effects of chloroform. 
Experiment XXYI.—To a small, quiet, and very easily managed 
pet dog, small doses were repeatedly given to see the smallest 
amount that would produce a noticeable effect upon the pulse ; 
\ minim every hour would, at the expiration of five or six hours, 
make a slight difference in the pulse, but | or | minim at like 
intervals produced no effect. 
Whenever I have found a dog more than ususlly quiet, I have 
repeated these experiments, and the limit at which it produces an 
effect is quite marked. The 3V minim every 15 minutes for four 
hours produces no noticeable effect. 
DIVISION SECOND. 
EXPERIMENTS ELUCIDATING THE PHYSIOLOGICAL ACTION OF THE 
RESINOID PRINCIPLE OF VERATRUM VIRIDE ON ANIMALS. 
Experiment I.—Five minims of the tincture, made from the 
resinoidprinciple alone, was injected by Wade & Ford’s hypodermic 
syringe into the cellular tissue of the right thigh of a dog weigh- 
ing about 14 lbs. The dog had eaten nothing for 14 hours. The 
pulse was 146. The same dose was repeated every fifteen minutes 
until eight doses had been injected; the pulse constantly and 
steadily diminishing. 
Five minutes after the eighth dose, the dog lay upon his side 
and would make no effort to get up; the pulse was 32. Four 
minim doses were then injected into the opposite thigh every five 
minutes. The fourth dose was hardly given before the heart’s 
pulsations ceased. Autopsy immediate. The heart was instantly 
exposed and both sides were found filled with blood. Upon the 
aortic valves, and forming a perfect network over them, were 
threads of fibrin, which adhered with much tenacity; but there 
was no appearance of inflammation and no doubt the fibrin had 
formed, in consequence of the sluggishness of the circulation, which 28 
prize ESSAY: 
for some fifteen minutes before death counted only 8 in the minute. 
With this dog the flow of saliva was very abundant, and the urine 
was passed involuntarily before death. 
Upon application of electro-magnetism, ten minutes after the 
heart was removed, the muscles were not excited into action. The 
lungs and mucous membrane of the stomach were congested. It 
was found that the last injection had passed into a vein. 
Experiment II.—To a large cur dog, weighing about 25 lbs., 30 
minims of the resinoid tincture of veratrum viride (containing 1J 
gr. of resin) were thrown into the stomach at— 
11.15 o’clock A. M. The pulse being 140 
12.10 “ P. M., repeated 20 minims. “ “ 117 
12.20 “ “ free salivation. “ “ 110 
12.55 “ « “ “ 84 
1 “ “ vomited many times in quick succession, 
the latter vomit being a tough, ropy 
mucus and much bile; the vomiting 
was painful and prostrating. Pulse 80 
1.15 “ “ pupils fixed. “ 76 
1.45 “ “ profuse diuresis and salivation. u 72 
1.47 “ 11 vomited several times, viscid mucus and 
, bile. 
3.30 11 “ sleeping. Pulse 70 
Experiment III.—To another dog, weighing about 20 lbs., 3ss 
of the same resinoid tincture, containing 1| gr. of resin, was given 
on a piece of bread, which was thrust down the throat. 
11 A. M. Pulse 144 
12 “ salivation. “ 124 
12.20 P. M. “ . 96 
12.25 “ vomited many times, the latter vomit being viscid, 
ropy mucus and bile. 
12.50 “ Pulse 80 
1.10 “ “ 74 
1.40 “ profuse diuresis, no dilation of pupils. “ 70 
3.35 “ quiet. “ 40 
Experiment IV.—Half a drachm of the same resinoid tincture 
was thrown, by the hypodermic syringe, into the cellular tissue 
under the fore leg of a dog weighing 25 lbs. PROPERTIES OF VERATRUM VIRIDE. 
29 
12.45 P. M. Pulse 96 
12.55 “ salivation. “ 72 
1 “ vomited and freely purged; vomiting continued 
until viscid mucus and bile were thrown up, 
and then bile alone. 
1.15 “ intense uneasiness and cries caused by the painful 
contractions of the diaphragm in vomiting. 
1.30 “ Pulse intermittent 52 
1.85 “ walks with unsteady and uncertain movements of 
the voluntary muscles, especially of the hind 
legs, which are kept wide apart. 
1.50 “ pupils widely dilated. Pulse 40 
3.30 “ salivation profuse, moaning cries and painful con- 
traction of the abdomen, respiration 84. Pulse 122 
This dog was well the next morning. 
Experiment V.—Twenty minims of the resinoid tincture were 
thrown into the stomach of a dog, whose weight was about 16 lbs., 
at 3.45 o’clock P. M., the pulse being 143. 
In ten minutes it vomited, and the same dose was repeated. 
4.20 P. M. Pulse 62 
4.35 “ profuse salivation, vomiting continued. “ 56 
5 “ injected 5 minims into the femoral vein. 
5.05 “ purged freely. 
5.10 “ vomiting viscid mucus and bile, pupils widely 
dilated. Pulse 36 
5.17 “ gave 2 oz. of brandy in water. “ 34 
5.20 “ no more vomiting. “ 46 
5.45 “ “ “ repeated the brandy. “ 56 
9 “ “ “ unable to stand, pulse thready, 
intermittent, could not be counted. During the 
next day it vomited several times, seemed in 
great pain, moaned, pulse could not be counted. 
Died during the night. 
Experiment VI.—Half a drachm of the same resinoid tincture 
of veratrum viride was thrown, by hypodermic injection, into the 
side of a large dog weighing about 30 lbs. 
11.45 A. M. Pulse 165 
11.56 “ saliva flows very freely, purged, restless. “ 106 
12.03 P. M. vomited freely viscid mucus and bile. 30 
prize essay: 
12.15 P. M. purged again, vomiting. Pulse 60 
12.30 “ pupils widely dilated, vomited clear bile. “ 52 
12.40 “ made an incision down to the femoral vein; he 
made no resistance and seemed to be uncon- 
scious of pain. Pulse 41 
12.44 “ injected 20 minims into the femoral vein, death 
was almost instantaneous. Both sides of the 
heart were full of bright chocolate-colored 
blood; the liver was gorged with dark llood; 
the mucous coats of the stomach and rectum 
were greatly congested; the other organs were 
healthy. 
Experiment YTI.—Half a drachm of the same resinoid tincture 
was thrown into the stomach of a large dog; when he had vomited 
freely, and was in the condition mentioned in Experiments II. and 
III., one grain of sulph. morphia was given in solution. There was 
no more vomiting, the dog became easy and quiet, and in forty 
minutes was sleeping soundly; the pupils were much contracted. 
The pulse remained for several hours about the same as when the 
morphia was given. He was quite well next day. 
DIVISION THIRD. 
EXPERIMENTS ELUCIDATING THE PHYSIOLOGICAL ACTION OF THE AL- 
KALOID VERATRIA OBTAINED FROM VERATRUM VIRIDE, AND FROM 
OTHER SPECIES, ON ANIMALS. 
Experiment I.—Ten minims of a solution containing | gr. of 
the alkaloid veratria made from veratrum viride, by Mr. George 
Scattergood, of Philadelphia, were given to a large dog weighing 
about thirty pounds, in gelatine capsules; great care was taken 
that none of it escaped into the mouth. 
3.35. P. M. Pulse 150 
4 “ salivation very profuse. “ 148 
4.05 “ vomited. “ 
4.20 lt vomiting very frequently. “ 140 
4.45 “ vomiting viscid mucus and bile. “ 128 
5.20 “ prostration very great, unable to stand. “ 122 
5.45 “ pupils widely dilated, eyes fixed. “ 122 
6 “ prostration great, profuse salivation. Intermittent 
9 “ walking about, but sober and dejected. 112 PROPERTIES OF VERATRUM VIRIDE. 
31 
Three days afterward the same dose was again given to the same 
dog, with very similar results. With this animal, the pulse was 
not much depressed, the prostration was very great, and there was 
almost total loss of power of the voluntary muscles. 
Experiment II.—One-third gr. of veratria (viride) was injected 
into the thigh of a dog weighing about fifteen pounds. 
3.40 P. M. Pulse 120 
4 “ saliva flows most profusely, purged. “ 100 
4.30 “ “ “ “ 100 
5.45 “ “ “ “ 100 
9 “ “ “ “ 92 
Experiment III.—A subcutaneous injection of f gr. of veratria 
(viride) was given to a coarse dog weighing twenty-five pounds. 
He had been well fed, and was very lively. 
3.35 P. M. Pulse 116 
3.40 “ very dejected appearance, free flow of saliva. 
4.15 “ repeated the injection of 1 gr. on the other side. “ 90 
4.17 “ purged. 
4.30 “ saliva flows freely, very dejected. “ 82 
4.35 “ vomited frequently, respirations labored, 
prostration very great, legs wide apart. 
5.15 “ prostration increases. “ 70 
5.20 “ painful vomiting every few minutes, unable 
to stand, gave 2 oz. of brandy in water. 
5.30 “ no vomiting since taking the brandy “ 88 
5.45 “ no vomiting, repeated 2 oz. of brandy “ 88 
9 “ no vomiting, very prostrate, unable to stand, pu- 
pils dilated and fixed, repeated the brandy. “ 98 
9. A. M. Next day—unable to walk steadily, stands 
over the water lapping every few minutes. 
Intermittent 170 
Recovered during the next day. 
Experiment IV.—A subcutaneous injection of | gr. of veratria 
(album) was made into the thigh of a small dog, weighing about 
six pounds. 
11.45 A. M. Pulse 110 
12.05 P. M. vomited freely, purged freely. “ 175 
12.20 “ vomiting continues. “ 180 32 
PRIZE ESSAY: 
12.22 P. M. repeated the same dose, but on the other side. 
1.10 “ prostration very great, unable to stand. Pulse 160 
1.25 “ administered Tq gr. of strychnia. Intermittent 80 
1.21 “ in violent convulsions, of which he died in a 
short time. 
Experiment V.—Ten minims of a solution containing ] gr. of 
veratria purified with great care from some of Powers & Co.’s com- 
mercial article, were given to a dog, whose weight was about twenty- 
five pounds, in gelatine capsules. 
10. A. M. Pulse 132 
10.15 “ saliva flowing freely. “ 130 
10.45 “ vomited several times in a few minutes. 
11.15 “ continues vomiting viscid mucus and bile. “ 126 
12 M. continues vomiting. “ 130 
2 P. M. continues vomiting, great prostration. “ 145 
4 “ continues vomiting, great prostration, di- 
lated pupils. “ 115 
5.45 “ unable to stand. “ 100 
Although walking about the next morning, he was dull and 
dejected, and ate but little, but drank water very frequently in 
small quantities. 
During the months of July and August, 1857, I tried thirty-one 
experiments upon dogs with the alkaloid, made by myself from 
veratrum viride, and with the commercial veratria made by Merck, 
for the purpose of ascertaining if they were alike in their thera- 
peutic action. 
My principal object was to ascertain whether they produced the 
same sedative effect upon the pulse as the tincture of the veratrum 
viride. 
From these experiments I learned that the alkaloid from the 
viride was more sedative in its effects upon the pulse than the com- 
mercial veratria; that it was less irritant, seldom causing an increase 
in the number of pulsations which the commercial veratria fre- 
quently did; that it produced vomiting and prostration in about 
an equal degree; that when a large dose was given, and prostration 
induced, there was most generally a dilatation of the pupils, but 
this effect was not produced by small doses; that purging was but 
seldom produced by either when given by the mouth, but nearly 
always when given by hypodermic injection; that large doses of PROPERTIES OF VERATRUM VIRIDE. 
33 
either, amounting to two grains at a time, might be given, producing 
alarming prostration, and most painful and protracted vomiting 
without causing death, if brandy, brandy and morphia, or tincture 
of cantharides was administered, and that in every instance the 
animal’s life might be saved by proper attention. 
In those instances where death took place from these alkaloids, 
it was caused by repeating the dose, and not by a dose of two 
grains administered at one time. Upon post-mortem examination 
the mucous membrane of the stomach was much inflamed, and in 
some instances the inflammation extended more or less through the 
whole intestinal tract, and was always seen at the rectum; the kidneys 
were in a state of congestion, and the heart filled with dark blood. 
When the dose was given by hypodermic injection, the results 
were somewhat different, as will be seen by reference to Experi- 
ments II., III., IV., of Division Third. 
Both alkaloids produced a sedative effect upon the pulse, but 
the commercial veratria did not to the same extent, as that from 
the viride, and neither of them to the same extent as the pure 
resinoid, or the tincture made from veratrum viride. 
The prostration was more complete, alarming and prolonged, 
and the vomiting was more painful and continued from the effects 
of the alkaloids than from the other preparations named. 
DIVISION FOURTH. 
EXPERIMENTS ELUCIDATING THE PHYSIOLOGICAL ACTION OF VERATRUM 
VIRIDE ON FROGS AND BATS, BY THE EXAMINATION OF THE CIRCU- 
LATING BLOOD WITH THE MICROSCOPE. 
As early as 1849 I experimented on frogs with veratrum viride, 
watching its effects upon the circulation of the blood with the 
microscope. 
At that time my experiments were made by throwing the sub- 
stance into the stomach of the frogs; since then I have repeated 
the same experiments, and have also used injection under the skin 
by means of the hypodermic syringe; and have experimented also 
by placing the frogs in water which was mixed with a certain 
amount of tincture of veratrum viride. 
I had but one object in trying these experiments, and that was, 
to watch the effects of veratrum on the circulation; so it will be 34 
prize essay: 
unnecessary for me to relate a large number of instances, and it 
will save time, and be quite as easily understood if I give the 
general effects produced. 
In these experiments it was my endeavor to subject the frog to 
as little annoyance as possible ; it was placed in a coarse linen bag, 
and the frog plate had a raised edge around it, so that it would 
hold water to keep the frog always moist. 
The bag had several holes at the end through which the mouth 
could be seen, and through which could also be introduced a small 
syringe, with a long nozzle, that would lead directly to the stomach. 
The circulation of each frog experimented upon was always 
watched before any medicine was administered, and every precau- 
tion taken to ascertain the normal circulation. The effects of 
veratrum viride on frogs were the same as on man and animals—a 
direct sedative to the vascular system. 
Doses of two minims of the tincture, diluted, when thrown into 
the stomach, with ten or fifteen drops of water, cause a marked 
diminution of the frequency of the circulation, in from three to 
fifteen minutes after administration, and the pulsations continue 
to decrease for one or two hours. If the water in which the 
frog lies is frequently changed so as to keep it cool, and the dose 
is repeated every hour, for two, three, or four successive hours, the 
effects may be watched until the circulation is so regular and slug- 
gish that the blood globules may be counted as they course through 
the smaller vessels, and the difference between the white and red 
disks, and their position in the larger capillaries, may be easily 
discerned. Sometimes the circulation would almost entirely cease 
in the web, but would return again in ten or fifteen minutes if the 
frog upon the plate was placed in fresh running water. 
It was always interesting to watch the cessation of the circulation 
and its re-commencement. 
When large doses of the veratrum viride were given by the 
stomach, the cessation of the circulation never occurred suddenly. 
There would be intermissions of longer or shorter duration; after 
each one, the current of blood when re-established would be slower 
than before, and after a while would cease. After it had ceased 
there would be an occasional throb, which would cause a general 
movement, but upon the subsidence of the impetus, the blood disks 
would be in about the same situation as-before. 
The occurrence of this throb was the first notice given of the 
return of the circulation : it would be repeated at shorter intervals, PROPERTIES OF VERATRUM VIRIDE. 
35 
sometimes a minute elapsing, and then several of such pulsations 
would occur in a minute. Then a short but general movement 
would take place of the blood-disks; at each pulsation, ceasing upon 
cessation of the vis a iergo, and again renewed, until the circulation 
was entirely established in a slow but steady current. 
I have frequently seen in the breaking up of this status, that the 
red disks do not, as in a normal state, occupy the central current 
only, but both red and white disks are mixed up heterogeneously, 
and some time elapses before the red disks again regularly take 
their place in the centre of the current. 
By hypodermic injection the same results as have just been 
spoken of occurred, but with greater rapidity and with one-quarter 
the dose that was administered by the stomach. 
One-half a minim thrown beneath the skin of the leg would 
produce the same amount of sedative effects in five minutes that 
two minims administered by the stomach would produce in an 
hour. I have frequently exposed both feet of the same frog, so 
that they could be examined separately, at the same instant by 
merely shifting the stage of the microscope. Into one leg I have 
injected two minims of the tincture, and the cessation of the circu- 
lation of that foot has been very sudden, whereas that in the other 
would be continued for some time, gradually becoming slower. 
Sometimes within one, generally within five minutes, the frog is 
apparently dead, so far as the circulation in the web is concerned, 
from the hypodermic injection of from two to five minims of the 
tincture; but if placed in fresh water, leaving the head exposed to 
the air, the frog will generally revive, and frequently will entirely 
recover, though sometimes it will partially revive and after all die 
within a day or two. 
With the frog, cessation of the heart’s action is not so sudden 
and complete as in warm blooded animals, and they will bear a 
much larger proportional dose of veratrum viride. 
The effects of veratrum viride on the circulation of the frog are 
seen with more satisfaction if it is administered in small and fre- 
quent doses thrown into the stomach. By hypodermic injection 
the effect is too sudden, but by the former method the circulation 
can be reduced gradually until it becomes so slow that the number 
of the blood disks passing in a given time may be ascertained, as 
well as their size and appearance. 
Upon the bloodvessels (capillaries, as well as arteries and veins) 
Yeratrum viride produces a sensible dilatation; and upon the blood prize essay: 
disks, the first effects are an endosmosis, an increase in their size; 
but as the effect of the medicine is continued to the second or third 
degree of its operation, there is an evident exosmosis, for they 
appear smaller in size. 
I have noted these effects upon the bloodvessels and upon the 
disks so frequently, that I am satisfied of the correctness of my 
observations. 
It is impossible, by any means known to me, to measure such 
differences in size, but an instructed eye can take notice of them, 
and although such effects may not be demonstrable to all, to one who 
will watch carefully and repeatedly, such differences may be seen.1 
These effects are produced so as to be properly obseryed only 
by small doses frequently repeated to the proper point, but large 
doses overpower the action of the heart and bloodvessels, and cause 
a paralyzing effect, sometimes amounting to cessation of the cir- 
culation. 
To satisfy myself more thoroughly on this point, I have placed 
frogs under the microscope in the method above stated, and after 
carefully examining the circulation, I have injected into the perito- 
neal cavity five minims of the tincture of capsicum, or cantharides, 
in a little water. The circulation was soon very much increased, 
and continued to increase with fearful rapidity. 
After a time, as the blood was propelled through the vessels 
with greater rapidity, there was a sensible contraction in their size. 
It seemed as though the vessels feeling the vis a tergo braced them- 
selves to meet the encounter. At this time I have administered 
veratrum viride by hypodermic injection. It exerted, in a few 
minutes, a marked sedative influence, though the pulsations were 
irritable and frequent. I have repeated the injection of veratrum 
at intervals, and closely watched the circulation. 
It controlled the pulsations, though not to the same degree as in 
health, and with large doses would check the circulation entirely. 
As the vessels were contracted in one instance by the inflammatory 
state produced, they were more plainly noticed to dilate under the 
sedative effects of the veratrum. 
Under these experiments (and I have repeated them many times) 
most of the frogs die of peritonitis; making it evident that if there 
are lesions, which produce an excited state of the circulation, a 
1 It is asserted tliat such differences can be measured. See Dublin Quarterly 
Journal of Medicine, Feb. 7, 1855. PROPERTIES OF VERATRUM VIRIDE. 
mere lessening of the frequency and force of the circulation will 
not effect a cure. But I will discuss this subject further, under 
the head of Modus Operandi. 
I administered veratrum viride several times to bats, and ex- 
amined the circulation under the microscope. The dilatation of 
the bloodvessels was as plainly marked as in the frog. 
When frogs were taken fresh out of the water, and the web 
placed under the microscope, I have frequently confined my atten- 
tion to one small capillary vessel. This capillary, that before the 
administration of the veratrum allowed but a single blood disk to 
pass at a time (the disks moving in a single file), would, when 
under the influence of the medicine, so dilate as to allow two glo- 
bules to move along together, not quite in line, but one slightly 
behind and at the side of the other; but, at the slightest obstruc- 
tion, moving up in line, and at the moment of the re-establishment 
of the circulation the one that was behind the other, by a change, 
would frequently take the lead. 
At one spot where there was a sudden bend or turn in the 
capillary vessel, but one disk would pass at a time, but not in the 
hurried manner noticed before the administration of the vera- 
trum. 
The movements of the disks by the operation of the medicine are 
rendered slow and orderly. The bloodvessels become passively 
dilated. 
I have tried various medicinal agents both with bats and frogs, 
but principally with frogs, to ascertain which is the best and quick- 
est antidote to remove this dilated state of the bloodvessels, and to 
increase the vigor of the circulation. I have found that the alcoholic 
stimulants have in most instances had the desired effect of in- 
creasing the vigor of the circulation, but, of all medicinal agents, 
tincture of cantharides is the most prompt and efficacious, as it not 
only increases the vigor of the circulation, but also induces as 
marked a contraction of the capillaries as veratrum does a dilata- 
tion, and that in this respect they are directly antagonistic. Codeia 
and other remedies have been used, but we shall speak of them all 
in their proper place. 38 
PRIZE ESSAY: 
SECTION FOURTH. 
THERAPEUTIC APPLICATIONS. 
DIVISION FIRST. 
THERAPEUTIC APPLICATION OF VERATRUM VIRIDE WITH RELATION 
OF A FEW CASES IN POINT. 
Case 1. Encephalitis. Louisa K., aet. 11 years. 
This young girl is of remarkably good constitution, and has not 
had a day’s sickness for si? years. 
On the morning of 4th of July, she was playing with her com- 
panions, and fell down the stone steps in front of the house, striking 
her head severely. She went into the house, complaining of pain 
in the head, and sickness at the stomach. Her mother kept her 
quiet until towards evening, when she allowed her to go to play 
again. During the evening one of her playmates pushed her down 
the same stone steps, and she again struck her head. She com- 
plained so much that her mother put her to bed. 
During the next day she complained of lassitude, creeping chills, 
and headache, and I was called to see her about 5 P. M. 
I found her suffering with an intense throbbing headache; she 
said that the pain was “inside the head;” the face was flushed, the 
eyes were injected, the right pupil dilated to nearly double the size 
of the left; there was great intolerance of light, it seemed to greatly 
increase the pain ; there was much thirst, but the water she drank 
was vomited up almost as soon as taken ; the skin was hot, the pulse 
was frequent and wiry, beating 174 in the minute. 
Upon examining the cranium, I could discover no injury, except 
a small ecchymosed spot on the right temple. I administered If 
gr. of podophyllin rubbed up with a little sugar. PROPERTIES OF VERATRUM VIRIDE. 
Date. 
Pulse. 
Treatment. 
Remarks. 
July 5th, 6 P. M. 
174 
Con. Tr. Ver. Yir. rn ii. 
7 “ 
176 
11 
u 
Plij- 
Occasional delirium. 
8 « 
174 
u 
u 
pUi- 
Delirium more marked. 
9 “ 
160 
ll 
n 
Plij- 
Vomited bile. 
10 “ 
110 
ll 
it 
Plij. 
11 “ 
93 
it 
u 
Plij- 
Vomited bile. 
12 “ 
79 
a 
u 
Plij- 
Constant chattering delirium, 
talking about her head. 
6th, 1 A. M. 
py- 
80 
n 
Pl’j- 
Bowels freely open, discharge 
bilious. 
2 “ 
72 
a 
u 
Plij- 
3 “ 
72 
u 
Plij- 
Bowels again opened. 
5 “ 
76 
Plij- 
6 “ 
70 
Noisy chattering delirium. 
8 “ 
70 
Bowels opened ; lies quietly. 
9 “ 
59 
Plij- 
Asleep for nearly an hour. 
10 “ 
48 
Respirations easy. 
11 “ 
44 
Free diaphoresis. 
12 “ 
41 
Bowels again opened ; talks in- 
1 P. M. 
coherently. 
42 
Right pupils still dilated more 
than left. 
2 “ 
56 
a 
it 
Plij- 
3 “ 
58 
it 
u 
Plij. 
5 “ 
60 
a 
n 
Plij- 
7 “ 
62 
it 
n 
Plij. 
9 “ 
64 
a 
n 
Pliij. 
Constantly talking about her 
head. 
10 “ 
54 
n 
n 
Plj- 
12 “ 
43 
n 
u 
py. 
Quiet, but answers incoherently. 
7th, 2 A.M. 
48 
n 
it 
Plij- 
Slept for twenty minutes. 
4 “ 
51 
u 
n 
Plij- 
6 “ 
49 
u 
u 
Plij. 
9 “ 
60 
n 
it 
Pliij. 
11 “ 
55 
u 
n 
Plij. 
Quiet. 
12 “ 
47 
u 
n 
Plj- 
Slept for an hour and a quarter. 
2 P. M. 
55 
a 
u 
Plij. 
5 “ 
62 
u 
n 
Pliij- 
7 “ 
54 
it 
u 
Plj. 
9 “ 
50 
it 
it 
Plj. 
Repeated the podophyllin. 
12 “ 
61 
u 
PUij- 
Slept for an hour and a half. 
8th, 2 A.M. 
47 
u 
u 
Plj. 
Bowels freely opened. 
4 “ 
53 
it 
u 
Plij- 
Bowels again opened. 
6 “ 
54 
u 
Plij- 
Pupils still of uneven size, 
8 “ 
though not so marked. 
55 
it 
it 
Plij. 
Asked where she was ; says her 
“head feels queer.” 
10 “ 
62 
u 
u 
Pliij- 
12 “ 
52 
n 
it 
Plij- 
3 P. M. 
53 
n 
u 
Plij- 
Slept for If hours. 
5 “ 
56 
a 
u 
Plij- 
7 “ 
57 
u 
ii 
Plij- 
Speaks consciously when ad- 
dressed, but is unwilling to be 
disturbed ; remains quiet. 
11 “ 
63 
it 
it 
Pliij 
9th, 1A.M. 
55 
u 
u 
Pliij 
Slept for 2f hours. 
4 “ 
55 
ti 
u 
Plij. 
7 “ 
58 
u 
it 
Pliij 
9 “ 
46 
Plj- 
Says she has no headache. 
10 “ 
50 
it 
u 
Plij- 
Pupils of the same size, and con- 
tract when exposed to the 
light. Light produces no 
pain in the head. 
1 P. M. 
61 
ti 
it 
Pliij 
4 “ 
58 
u 
it 
Plij- 
7 “ 
57 
u 
it 
Plij. 
Slept two hours. 
10 “ 
62 
u 
it 
Pliij 
Has no pain. 40 
PRIZE ESSAY: 
As the little patient seemed so much relieved, the medicine was 
continued in two minim doses every three hours. The bowels 
were kept freely open by rhei et soda, and on the evening of the 
10th all remedies were discontinued, but quiet and a low diet 
enjoined for several days, under which she recovered her usual 
health. During this treatment her only food was powdered 
crackers boiled to a jelly. The urine could not be collected. It 
will be seen, in the treatment of this case, that the child’s tolerance 
of the remedy was very great; it was borne in larger doses than is 
usual with many adults. 
There was no vomiting from the effects of the remedy, and par- 
ticular caution was used throughout the whole time of treatment 
to prevent it, as the excitement caused thereby would probably 
increase the trouble of the brain, and compel the cessation of the 
remedy for a time. The vomiting that existed before and during 
the early part of the treatment was controlled by the sedative 
action of the veratrum upon the brain. 
Case 2. Pneumo-pleuritis. Miss M. A., set. 37 years, of a nerv- 
ous, bilious temperament, good muscular development, weighing 
134 lbs.; went to bed feeling slightly indisposed, and was annoyed 
on rising in the morning with frequent slight rigors. About 10 
o’clock A. M. these rigors were succeeded by flashes of heat; the 
tongue became dry and parched with considerable thirst. 
About 2 o’clock P. M. she had a severe chill, which lasted 20 
minutes, and which was followed by much fever, with a sense of 
constriction across the chest, and a teasing, tickling, painful cough. 
About 4 o’clock P. M. she complained of a severe stitch in the 
right side, about two inches to the right of, and a little below the 
nipple. The pain and fever continued to increase, and the cough 
was troublesome. I saw her at 6 o’clock P. M., Oct. 10th. The 
pulse was 164, the skin hot and dry, the face flushed; had passed 
no urine since morning, and had had no operation of the bowels 
for twenty-four hours. 
Upon examination by auscultation I could distinctly discover 
crepitation over the whole of the right lung; the left was unaffected. 
The vesicular murmur was heard in front, but not behind on the 
lower lobe of the right lung. I immediately administered a brisk 
cathartic, and applied a large hot poultice to the seat of the pain. PROPERTIES OF VERATRUM VIRIDI 
Date. 
Palse. 
Respira- 
Treatment. 
Remarks. 
tions. 
Oct. 10th, 6 P. M. 
164 
30 
Tr. ver. vir. nqv. 
Passed 2 oz. urine, sp. gr. 
1.018, which on standing 
deposited am.mag. phosph. 
160 
7 “ 
30 
it 
“ Pliij- 
8 “ 
146 
27 
it 
“ Plij- 
9 “ 
100 
27 
ti 
“ Plj- 
10 « 
94 
27 
/ S. morph, gr. J 
l 1 r. ver 
vir. "luj. 
11 “ 
81 
23 
Tr. ver. vir. rqij. 
Bowels open; urinated. 
Pleuritic pain much relieved. 
12 “ 
59 
20 
11th, 1 A. M. 
57 
20 
I left with directions to give 
2 minims every hour if the 
pulse rose to 80 or over, 
hut it was not done. 
6 “ 
96 
24 
Tr. ver. vir. Tqv. 
7 “ 
91 
23 
it 
“ Plv. 
Pleuritic pain quite severe. 
8 “ 
67 
23 
Vomited a viscid mucus. 
Crepitation still heard. 
9 “ 
51 
20 
S. morph, gr. 
Pleuritic pain relieved. 
11 “ 
58 
19 
Tr. ver. vir. Plij. 
Free diaphoresis. 
1 P. M. 
60 
19 
ti 
“ Plij. 
Passed 14 oz. urine, sp. gr. 
1026, acid. 
3 “ 
61 
20 
It 
“ Plij- 
5 “ 
66 
20 
(i 
‘£ Pliij- 
Bowels opened. 
7 “ 
63 
21 
\ S. morph, gr. 
Expectoration easy. 
9 “ 
61 
19 
Tr. ver. vir. PI ii. 
Passed 9 oz. urine, sp. gr. 
1027, acid. 
12 « 
67 
20 
( S. morph, gr. 
/ Tr. ver. vir. Pliij. 
12th, 3 A. M. 
66 
18 
it 
“ Plij- 
6 “ 
62 
18 
it 
“ Plij- 
Passed 11 oz. urine, sp. gr. 
1026; bowels opened. 
9 “ 
65 
18 
it 
“ Pliij- 
No crepitation in upper lobe. 
11 “ 
64 
iq 
$ S. morph, gr. J. 
Diaphoresis very free; ex- 
£ Tr. ver. vir. Ppij. 
pectoration easy. 
3 P. M. 
66 
17 
tc 
“ Pliij- 
With the last 2 hours 27 oz. 
of urine have been passed, 
sp. gr. 1024. 
7 “ 
67 
18 
It 
“ Pliij- 
10 “ 
66 
18 
it 
“ Pliij- 
Upon auscultation at this time I found the crepitation had en- 
tirely ceased, excepting at a small circumscribed spot near the base 
of the lung; expectoration was free and easy, and had no rusty 
color. The veratrum was continued in doses of three minims 
every three hours, until the morning of the 14th, when all remedies 
were suspended, as the crepitation had ceased, and the normal 
respiratory murmur was heard over the whole lung. 
It will be noticed in this case that the veratrum controlled the 
pulsation, but that it was necessary to combine it with morphia, 
to control the respirations, and relieve the nervous irritability of 
the system. It will also be noticed, that as the disease was 42 
prize essay: 
brought under control the urine increased not only in quantity, 
but also in specific gravity. 
Any person who treats a case of pneumonia with this remedy, and 
daily examines the auscultatory signs, will be pleased to find that he can 
with ease hear every sound, and arrive at a correct diagnosis of the 
state of the lungs, ivhen without this remedy the sounds will be obscure. 
In the relation of the two preceding cases, I have given the 
treatment and noted the number of pulsations from hour to hour. 
In the experiments upon animals the number of pulsations in the 
minute are also frequently noticed. It would seem unnecessary, 
therefore, in the relation of the following cases, to be thus minute; 
but as there are cases in which this remedy produces to the friends 
of the patient, and sometimes even to the physician, alarming 
effects, I will take one of these as a type and relate it as I have 
the foregoing. 
Case 3. Pneumo pleuritis. William T., set. 11 years. A dull 
boy of leuco-phlegmatic habit, whose mother died of phthisis, 
complained of a sharp pain on inspiration, in the lower portion 
of the right lung, and an uneasy, tickling cough. He had rested 
badly all night, and complained of alternate chills and fever. The 
skin was hot and feverish, the pulse 165, the respirations 32. 
Upon auscultation, crepitation was heard all over the lower lobes 
of the right lung, and over a portion of the upper lobe of the left 
lung. He was reclining in a rocking chair, as he said it was hard 
to breathe when lying down. 
About an hour before I saw him he had eaten a bowlful of 
warm bread and milk, so that I thought it better to give him no 
purgative medicine until after the food had digested. He passed 
about half a pint of urine of acid reaction and sp. gr. 1014. 
Date. 
Pulse. 
Respira- 
tions. 
Treatment. 
Dec. 4th, 10 A. M. 
165 
32 
Con. Tr. ver. vir. Rtiij. 
11 “ 
165 
32 
“ “ nij- 
12 “ 
164 
32 
“ “ n^iv. 
1 P. M. 
164 
31 
“ “ V\iv. 
2 “ 
160 
32 
“ “ Tt^iij. 
About 2.45 P. M., I was sent for in haste, as the boy had vomited 
the bread and milk, which smelt very sour and disagreeable. 
After vomiting he lay back, very pale and faint. When I saw 
him about 4 o’clock, the friends were very much alarmed, and had 
sent out for the first physician they could find ; he told them the PROPERTIES OF VERATRUM VIRIDE. 
boy was dying, and had sent to the druggists for brandy and car- 
bonate of ammonia. 
The boy was on his back, very pale, and looking like one who 
had lost a large quantity of blood. He was bathed in a profuse 
perspiration, which stood in drops upon his forehead and face; the 
hands were outside the bed covers, and were cold and very moist; 
the feet were covered, and were warm, and also very moist; the 
respirations were 19 in the minute, and the pulse 41, full and soft. 
Upon being spoken to he said that he felt free from pain, but sick 
at the stomach if he moved; he requested to be let alone, as he 
felt well if undisturbed. 
I did not allow the brandy and ammonia to be given, but 
covered him and applied warm bottles to the hands and feet. T 
gave him nothing. At 5 o’clock the pulse was 44, the respirations 
18; at 6 o’clock the pulse was 52, the respirations 18; at 9 o’clock 
the pulse was 62, the respirations 20. 
He had slept for two hours. He passed about a pint of urine, 
slightly acid and sp. gr. 1026. I left directions to give him two 
drops of tincture of veratrum viride, every two or three hours 
through the night, according to the state of the pulse. At 8 o’clock 
the next morning the pulse was 60, and the respirations 19 in the 
minute; there was no crepitation to be discovered over either lung. 
In this case, both the physician and the boy’s friends were much 
alarmed, and they insisted on giving the brandy and ammonia; 
and had not the father sustained me, I should have been obliged 
to leave. I was in error that I did not administer an emetic to 
empty the stomach before giving the veratrum, and especially when 
I found that it produced no effect for some hours. 
Case 4. I was called to attend a young woman with pneumonia 
of the left lung; she was between the eighth and ninth month of 
pregnancy. Her own pulse on my first visit was 152, and the 
pulsation of her foetus too fast to count. At the expiration of eight 
hours, under the use of veratrum viride, her own pulse was 82, 
and that of her foetus 112. The medicine was continued, and pro- 
duced slight vomiting, after which her pulse fell to 58, and that of 
her foetus to 88. On the third day after ceasing the medicine her 
pulse was 86, and that of her foetus 164. 
Case 5. Acute Eheumatism. J. D., set. 37 years, of bilious tem- 
perament. Has had two severe attacks of rheumatism previous to PRIZE essay: 
the present one. The first attack was treated several years ago by 
Dr. Warren, of Boston, and the patient was confined to his bed for 
seven weeks, and recovered from it, but with valvular disease of 
the heart. The bellows murmur is distinctly heard, and is audible 
with the first sound of the heart, in the carotids. During the second 
attack I attended him, and he was confined to his bed for fifteen 
days, the treatment being principally with aconite. The cardiac 
trouble was not increased. 
Jan. 8, 1857.—The present attack was induced by riding in an 
open sleigh, and indulging too freely in eating and drinking on 
Jan. 1st. The pulse was 146, strong and full, the bowels constipated, 
the urine so scanty as to be almost suppressed, the tongue furred 
with a reddened margin, the skin hot and dry, the left knee very 
painful and much swollen, and he declares it to be more painful 
than ever before. 
There was a sense of soreness and constriction over the heart, 
with an increase in the intensity of the bellows murmur. The 
urine was acid and of sp. gr. 1.021. I gave two grains of podo- 
phyllin rubbed up with liquor potassa and water, and determined 
to bring my patient as quickly as possible under the influence of 
veratrum viride, but felt the necessity of watching him very closely? 
as I feared that with valvular disease of the heart, and consequent 
obstruction, its pulsations might easily be reduced too low. 
I remained with my patient the first eight hours, and gave the 
veratrum in small and frequently repeated doses, carefully watch- 
ing its effects upon the circulation. As he came under its influence 
the sounds of the heart were determined with great exactness, pre- 
viously the sounds were tumultuous and inappreciable. 
When I left, the pulse was beating 80 in the minute, soft, full and 
more regular; the palpitations had nearly ceased, as well as the 
sense of soreness and constriction about the precordia. The bowels 
had been freely acted upon. The urine had passed more freely, 
the skin was moist, and the knee, which was covered with oiled 
silk, was somewhat easier. The urine was acid, and sp. gr. 1023. 
I left the patient in the care of a very intelligent friend, who ad- 
ministered the veratrum in doses sufficient to keep the pulse about 
eighty. 
4th. During the whole of this day, by means of the veratrum, 
the pulse never exceeded 80, and twice it was found to be as low 
as 72. The pain was very much diminished, so that he was ena- 
bled to sleep. PROPERTIES OF VERATRUM VIRIDE. 
The feverish condition of the mouth was much relieved. The 
bowels were again opened, and the discharge bilious. The urine 
was more free, of dark color and acid reaction, of sp. gr. 1.027. 
5tli. The patient is very much easier, and allows the knee 
to be washed and moved without much complaint; the swelling 
and redness have diminished. 
The pulse during the twenty-four hours was kept about 75, by 
administering the veratrum every one or two hours, according to 
necessity. He has slept fully half the time. Urine slightly alkaline, 
of sp. gr. 1.032. 
6th. This morning I found my patient in his dressing gown, 
and sitting in his easy chair; he walked up and down the room 
several times; the soreness in the knee was quite gone, but as it 
existed to a slight extent in the ankle, I concluded to continue the 
veratrum for twenty-four hours longer, keeping the pulse at a 
maximum of 80. The podophyllin and liquor potassse were re- 
peated, and produced nausea and free purging. Urine alkaline, 
sp. gr. 1.028. 
7th. The patient declared himself quite well, and the vera- 
trum was discontinued. He asserted that for four years he had 
not felt so free from trouble about the heart. 
The bellows murmur was much softer in its sound, and as the 
pulsations were more slow and regular, it could be more distinctly 
appreciated. (See Case No. 10.) I wished to continue the use of 
the veratrum for some time, in doses sufficient to control the 
pulsations, but at longer intervals, to see if it would have any 
effect on the valvular disease, but the gentleman was unable to 
remain with me any longer. 
I have since then, whenever time and opportunity would permit, 
used veratrum in investigating diseases of the heart and aneurisms, 
and those who have not tried it for those diseases will be pleased 
to find the assistance it renders to a clear diagnosis. 
For some four years previous to 1850, I used aconite for most 
of the cases of rheumatism that came under my care, being in- 
structed in this treatment by the study of Dr. Fleming’s most ad- 
mirable treatise on that plant, but since 1850 I have used veratrum 
viride in cases of rheumatic fever, unaccompanied with neuralgia, 
with much better success than aconite. 
There are cases of rheumatic fever with more neuralgiac diffi- 
culty than is common in the disease; in such cases skilful combi- 
nations of aconite with veratrum viride have given quicker relief prize essay: 
than either remedy alone. Aconite is a preferable remedy, for that 
form of neuralgic or irritative rheumatism, unaccompanied by high 
arterial excitement. 
For several years I have treated cases of acute rheumatic fever 
with veratrum viride, and with better results than with any other 
remedy, and the case above referred to is not by any means a soli- 
tary one upon my note-book, in which the disease was relieved in 
a few days. With many of these cases I have used morphia in 
combination with it. With most of them, an alkali has been given 
at least once in the twenty-four hours, for the purpose as before 
expressed, of relieving the irritability of the stomach, and preventing 
nausea and vomiting from the veratrum. 
In cases of rheumatic fever, the urine generally becomes neutral, 
under the proper administration of veratrum viride for forty-eight 
to sixty hours. 
In this, as in other diseases of the heart, the abnormal sounds could 
he more easily estimated as the patient came under the influence of the 
remedy ; prior to its sedative action a correct diagnosis was exceedingly 
difficult. 
Case 6. Mammary Inflammation. I attended a stout muscular 
young woman in her confinement. About the tenth day, from 
neglect on the part of the nurse, there was much trouble with the 
breast, and I feared a mammary abscess. In addition to other treat- 
ment, I administered a full dose of veratrum viride, and repeated 
it in an hour. In one hour and three-quarters from the time the 
first dose was given, free vomiting took place. After the vomiting 
ceased, the veratrum viride was continued in as full doses as she 
could bear, and the pulse kept at about 50 beats in the minute all 
that night. 
Early in the morning the child was allowed to nurse. About an 
hour afterwards I was called in haste, with the message that the 
child was dying. I found it in a prostrate condition, with a very 
low* pulse. It had vomited many times, and was still retching. A 
little warm gin and water soon revived it. 
The woman’s breast was doing well, with much less pain and 
inflammation. Her sister, who was in the same house, and who had 
a babe but a few weeks old, promised to nurse this babe also. 
I continued with the veratrum, and determined to try if I could 
get proof of the fact that the medicine had caused the babe’s vomit- 
ing. A few hours afterwards, I drew out all the milk I could from 
both breasts, amounting to about 6 oz. I brought away a 4 oz. vial 47 
PROPERTIES OF VERATRUM VIRIDE. 
full, the balance I gave to a kitten. It made the kitten very 
sick, and caused it to vomit several times. By adding acid I 
coagulated the milk, and filtered off the whey, which was evapo- 
rated. The extract was treated with chloroform, filtered and allowed 
to evaporate; this was then treated with ether and again allowed 
to evaporate; the residue was treated with alcohol and evaporated. 
To an acid solution of this filtrate, a solution of chloride of 
gold was added, which produced a turbidity of a yellow color. 
With the tincture of iodine, a small brown precipitate was formed. 
Tannin, and ammonia produced a white precipitate. 
All the urine which had been passed for sixteen hours was filtered 
and evaporated, and the residue treated as above mentioned, with 
the same results, but more marked. Here then was proof that the 
veratrum had been absorbed into the blood; had produced its 
characteristic effects, upon the child and upon the kitten, through 
the milk, and it was chemically detected in both milk and urine. 
The doses administered were, in this case, large ; they were long- 
continued, and produced the characteristic depression of the pulse. 
The inflammation of the breast was promptly relieved. 
Case 7. Chorea, or Acute Hysteric Chorea. 
Anna W., set. 14 years. I had cured this young girl of chronic 
chorea about one year and a half ago. 
At the commencement of the present attack, the girl was in the 
country with her mother. After a day of unusual fatigue, spent at 
a picnic, the child was entertained with ghost stories in the 
evening. 
She slept but little that night, and the convulsive movements of 
chorea commenced in the right side. During the day the convul- 
sive movements increased, and the child expressed a constant dread 
of something, and was unwilling that her mother should leave her 
side for a moment. She slept none during the next night. In the 
morning, upon her mother leaving her for a minute she screamed 
violently, and from that time the convulsive movements increased 
in intensity. 
She passed another sleepless night. Dissatisfied with the medi- 
cal treatment she received, her mother left the country and brought 
her with her, but with difficulty made the change from the cars to 
the carriage. 
When I saw her she looked in a truly pitiable condition. She 
had not slept for over sixty hours; it was with great difficulty that she 48 
prize essay: 
could swallow a teaspoonful of water; her eyes were injected, and 
had a glassy stare; the pupils were contracted; the face was suf- 
fused ; the pulse thready and very rapid. 
The convulsive movements were almost incessant, every muscle 
seeming to be in perpetual motion. 
The hypodermic syringe was in my pocket, and I at once threw 
into the cellular tissue of the right arm five minims of concentrated 
tincture of veratrum viride. I left for about twenty minutes, to 
get some morphia and other remedies that I thought I might need. 
When I returned the child said she felt easier, and there was a 
slight improvement in her appearance. The same quantity of 
veratrum was repeated in the same manner. 
In an hour from the administration of the first dose the pulse 
was slower and softer, but could not be counted, owing to the mus- 
cular movements. She expressed sensible relief, and took a small 
quantity of farina gruel. About fifteen minutes afterwards, she 
said she felt sick at her stomach ; large drops of perspiration stood 
upon her face and forehead; the convulsive movements continued 
to grow less, and she said she felt free from pain. She did not 
vomit, but felt quite sick if she moved. 
I assisted her to undress, and by smoothing her head, induced 
her to keep quite still, and shut her eyes. In two hours and 
seventeen minutes from the time of giving the first hypodermic 
injection she was asleep. 
I allowed her to sleep two hours, and then roused her to give her 
some soup with gr. of morphia, and two minims of tr. veratrum. 
While awake, the convulsive movements were renewed, but in 
a moderate degree. She soon went to sleep again. 
After sleeping three hours she was again awakened, and had a 
large warm injection administered, as her bowels had not been 
opened during the attack. The injection brought away a large 
quantity of hard fecal matter. She remained awake about an hour. 
I administered three minims of tr. veratrum, and gr. of morphia, 
in an aperient mixture. 
She went to sleep at 2 o’clock A. M., and was not awakened 
until 6 o’clock. The convulsive movements had then nearly ceased. 
I continued the veratrum combined with iron and quinia for 
some time. The disease has not since returned. 
Case 8. Facial Neuralgia. I was called to see a stout plethoric 
servant girl, and was told that she was suffering with acute face- 49 
PROPERTIES OF VERATRUM VIRIDE. 
ache. I found her suffering with acute facial neuralgia, the 
pain extending over the whole of the right side of the face, with 
toothache and earache. Her features were quivering with pain; 
she seemed unable to be quiet for a moment, and she declared that 
she had not slept for two nights. Her pulse was 147 in the minute.• 
With the hypodermic syringe I injected six minims of the concen- 
trated tincture of veratrum viride, under the angle of the jaw. In 
two minutes, she said the pain was gone, and only the soreness 
was left. The girl was almost frightened at the quick relief, and 
declared it to be a miracle. 
I gave her a full dose of purgative medicine, and sent her to bed. 
The relief was permanent. 
Case 9. Sciatica. A stout laboring man, of scrofulous appear- 
ance, whose leg had been broken, complained of acute sciatica. I 
injected with the hypodermic syringe five minims of concentrated 
tincture of veratrum viride into the popliteal space. The relief 
was almost immediate, and continued nearly five hours. As the 
pain returned, the same dose was repeated with like effect, the 
relief lasting four hours. The same dose was again repeated, but 
with the administration by the mouth of two grains each of .pulvis 
ferri and sulph. quinia every hour. The pain did not return. 
During the first nine hours the pulse decreased 72 beats in the 
minute; there was no vomiting, but much nausea. 
Case 10. "Valvular Disease of the Heart. (See Case 5.) E. J., aet. 
38. A stout muscular laboring man, who had until within a few 
months been a sailor. He has been living for the past two months 
in a dark unventilated basement. 
When I was first called to see him, he was suffering with the first 
stage of pneumonia, which was plainly diagnosed by the physical 
signs. The dyspnoea was very painful. The pulse was wiry, in- 
termittent, and too rapid to be counted. On applying the ear over 
the heart, a murmur was heard, but with which sound it was im- 
possible to determine; there was also distinct intermission with 
every few beats of the heart; this, with the murmur, could be easily 
distinguished upon the opposite side of the chest. 
He said he had not felt as well as usual since he had lived in 
this place, and attributed it to the want of sea air rather than to 
the dark, damp, and unventilated condition of his room. 50 
PRIZE ESSAY: 
About four years previous to his present sickness, he had a very 
severe attack of acute rheumatism, which, as the doctor had told 
him, had left him with disease of the heart; but it had not troubled 
him to any very great extent. 
* As the pulsations were so exceedingly rapid, and as there was 
probably organic derangement of the heart, I put him with other 
treatment upon the use of moderate doses of veratrum viride, to 
control the circulation, and to enable me to ascertain the cause of 
the intermittent pulsation and cardiac murmur. By the use of the 
veratrum, the pulse was reduced in twelve hours to about 60 
beats in the minute, with an intermission every eighth or tenth 
beat. 
The veratrum was continued until the pulse was about 50 in 
the minute, the murmur could then be heard very distinctly. The 
diastolic impulse was feeble and irregular, followed by a purring 
thrill that was heard distinctly towards the apex of the heart: this, 
from the slowness of the heart’s movements was heard quite dis- 
tinctly from the louder murmur that followed the systole. This 
systolic murmur could be heard by applying the ear over the right 
lung, especially beneath the clavicle, but its greatest intensity was 
at the base of the heart, and also in the carotids, and became less 
easily distinguishable towards the apex. 
By the slow action of the heart these two sounds could be 
separated, and heard with great distinctness; the one at the apex, 
and the other at the b'ase of the heart. They denoted valvular 
disease with regurgitation in both the mitral and aortic valves. 
As I have before stated in general terms, veratrum viride in 
these cases of disease of the heart is of special value, not only in 
the treatment, but also in enabling the physician to arrive at a cor- 
rect diagnosis. It lessens the irritability of the organ, and thus 
gives character to the rhythm, and evidently from the volume 
and regularity that it gives to the pulse, there is a more complete 
contraction of the chambers of the heart. 
Without the use of veratrum viride I could not have made this 
diagnosis; and although I could not by the knowledge of it restore 
the integrity of the valves, I could and did for some time, by pro- 
per care, prevent an increase of the difficulty. 
After the danger of the pneumonia had passed, my first care 
was to remove him to a light, well-aired room, and as soon as 
possible put him on the use of hrematic remedies, with small doses 
of veratrum viride, and a plain nourishing diet, so as to get the 51 
PROPERTIES OF VERATRUM VIRIDE. 
blood into a healthy condition, and thus prevent the irritability 
induced by impoverishment. 
Not liking a life on shore, he again went to sea. I saw him 
after his return from two voyages; but during the third voyage 
he fell dead from the rigging of the ship. 
Case 11. A woman aged 65 years had frequently sent for me 
to relieve her of urgent dispncea, which was supposed to be asth- 
matic. The attacks were generally induced by bursts of ill temper, 
or by fretting. I had used several remedies, but the tincture of 
veratrum viride gave her more permanent relief, and was at last 
the only remedy used. 
The present attack was caused by grief on receiving news of 
the death of a child. The dispnoea was painful, the respirations 
were very frequent, the pulse thready; there was great thirst, and 
frequent fainting fits. She died before I arrived, as the friends 
said, of suffocation. 
On a post-mortem examination ten hours after death, the lungs, 
heart, stomach, and kidneys were found perfectly healthy ; but on 
closely examining the lungs to ascertain if there was any change 
in their structure, caused by the frequent attacks of asthma, I 
found that the lining membrane of the pulmonary veins was 
covered in many places with large patches of opaque substance, 
somewhat redder in color than the lining membrane of the vessel. 
These patches were of different size, some of them occupying 
more than one-half of the calibre of the vessel, others quite small 
and occupying distinct points. 
The larger patches were thicker than the small ones, and on 
some of them, distinct lamellse could be peeled off. As though 
their presence upon the inner coat of the vessels was not impedi- 
ment enough, their favorite seat seemed to be just beyond where 
the two vessels united; in this place they were larger and thicker 
.than elsewhere. 
This I suppose may be called hypertrophy of the lining mem- 
brane of the vessels. It existed to a great extent over both pul- 
monary veins, and several patches of large size were found in the 
aorta, the largest just beyond and almost in connection with the 
aortic valve. 
There was no bony deposit in any of them, and I-do not know 
if there would have been bony depositions, if the patient had lived 
longer. 52 
PRIZE ESSAY: 
The color of those in the aorta were more of an opaque grayish- 
white, while those in the pulmonary veins were reddish and appa- 
rently much congested. 
The result of the post-mortem fully accounted for the benefit 
derived from the use of the veratrum viride, in preference to other 
remedies, as its sedative action tranquillized the circulation, and, as 
we have seen in the experiments upon frogs and bats, dilated the 
vessels. 
Case 12. L. J., set. 8 years. I found this child very ill with 
double pneumonia, the pulse was wiry and too rapid to count. I 
gave her veratrum in large doses, but it produced but very little 
effect upon the pulsations or respirations. She was partially un- 
conscious, throwing her arms wildly about her, constantly smack- 
ing her lips, and straining as though she wished to swallow some- 
thing. She remained in this unpromising condition without relief 
for twenty-four hours, and with no diminution in the frequency of 
the pulse, although very large doses of veratrum were given. 
Feeling that there was some cause of irritability in the stomach, I 
gave her a drachm of sulphate of zinc. She almost immediately 
vomited a large quantity of yellow, viscid, ropy mucus, and with 
it two large worms (ascaris lumbricoides). 
Without the administration of any more veratrum, within one 
hour from the removal of these worms from the stomach, the pulse 
was beating 82 in the minute, soft and compressible, and was re- 
duced at least 100 beats in the minute. The countenance was pale, 
the skin moist, and the respiration easy. 
The child became suddenly alarmed, and screamed, and kicked 
off the bedclothes. Another large worm, 7£ inches in length, 
was found alive in the bed just passed from the anus. From this 
time the child did well, and in three days was dressed and sitting 
up. 
We have many instances to convince us that the presence of 
taenia, or lumbricoides will greatly derange the action of the heart; 
but have we sufficiently noted that they prevent, retard, or inter- 
fere with the action of medicine? PROPERTIES OF YERATRUM VIRIDE. 
DIVISION SECOND. 
THERAPEUTIC APPLICATION OF VERATRUM VIRIDE IN TYPHUS AND 
TYPHOID FEVERS. 
It has been frequently asserted by many who have written on 
this remedy, that it is a specific in these fevers, and that with it 
they could “cut short the fever in from twenty-four to forty-eight 
hours.” We must confess that such persons know its uses better 
than we do, or else that they are mistaken in their diagnosis, for 
we have never met with such success. 
It is true that with this remedy the heart’s pulsations can be 
controlled, and that so long as its use is persisted in “ the fever” is 
moderated ; but as the fever and arterial irritation are but symp- 
toms, and caused by a morbid material within the system, and are 
not the disease itself, or the cause of the disease, we cannot see 
how it should by its sedative effect “ cut short the disease in from 
twenty-four to forty-eight hours.” 
There are few diseases of equal severity wherein the circulation 
is so little roused to excessive action, as in typhoid fever, the 
character of the pulse being one of irritability, or at least of 
asthenic inflammation rather than of active inflammation. 
It may, perhaps, seem strange to some that a remedy that is 
used with such marked success in sthenic diseases should under 
any circumstances be recommended for diseases of a directly 
opposite character. But in sthenic diseases it is used iri large 
doses, and its power is promptly spent in controlling the excessive 
action of the heart and arteries, and its neurotic or nerve action is 
not so much noticed, because it is secondary in importance; but 
in asthenic diseases, if judiciously administered in small doses, 
and kept within proper limits, its nerve action is more perceptible, 
quieting the irritability of the nervous system, and the irritable 
state of the circulation, permitting the pulse to become fuller in 
volume, and more normal in character. 
In one disease we have excessive arterial excitement and im- 
petuosity of the heart’s movements, and we endeavor to control 
that violent action, and bring back the pulsations to a normal 
standard; in the other we have nervous excitement with depres- 
sion, causing the heart’s movements to be irritated, weakened, and 
quickened, producing a continual slow fever; and by quieting that 54 
peize essay: 
nervous excitement we lessen the irritability and prolong the sys- 
tolic movements; in both cases we seek to bring the heart’s pulsa- 
tions to a normal standard, and by so doing we lower the fever, 
and by this means alone prolong existence. 
The consecutive effects of veratrum viride are, in typhoid fever, 
of great importance. In this fever the skin is generally dry, the 
tongue smooth and parched, and the secretions lessened. 
Under the judicious use of this remedy the skin becomes moist, 
the salivary glands secrete freely, the urine is more abundant, the 
expectoration is easier and more free; and although the bowels are 
not acted upon by it, the irritability of the intestines is lessened, 
and therefore there is less necessity for laxatives; and if they are 
given they are required in smaller doses. 
In one respect, I believe this remedy acts in a directly opposite 
manner to narcotics, for whereas narcotics suspend proper oxida- 
tion and elimination, this increases the oxidizing power of the 
system. 
As grave and serious alterations in the structure of the muscular 
tissues of the heart frequently take place in typhus fever, and as 
these morbid changes are similar in character to those which result 
from sthenic congestion and inflammation of the muscluar tissues 
of this organ, it is exceedingly important that the physician should 
closely watch the peculiarities of the action of the heart, and devote 
special attention at each visit to its impujse and intonations. 
There are numerous instances in typhus fever where, early in the 
disease, the heart’s action becomes exceedingly feeble, and its sounds 
denote that the muscular structure of the organ has become ener- 
vated, and that the propulsive power is weakened, independently 
of the insufficiently stimulating character of the blood. 
Even the best authorities in these cases have not yet decided 
that this change is not the result of inflammatory action, and 
although we know that the stimulating plan of treatment is abso- 
lutely necessary, for by its means only can we maintain the proper 
force of the heart, we find that the irregular, frequent, and true 
asthenic pulse becomes more regular, less frequent, and of better 
tone and energy by the proper and careful administration of small 
doses of veratrum viride. 
In many cases of typhoid and typhus fever there are periods 
when this remedy is of very great value, as it steadies the action 
of the heart by lessening its irritability, insures the complete 
contraction of its chambers, and thereby gives volume to the pulse PROPERTIES OF VERATRUM VIRIDE. 
55 
and regularity to its intonations; it also acts favorably by its con- 
secutive eliminative power. 
But it is no “specific” for typhoid fever (as Norwood and others 
assert), “ breaking up many cases at the very outset,” and “ curing 
others in from 2d to 48 hours.” It is to be regretted that any 
physician should make so irrational an assertion. 
In these diseases it should only be administered in small doses, 
as large ones produce excessive prostration, and thereby injure 
rather than benefit the patient. 
IN PHTHISIS: ALSO AS A MEANS OF DIAGNOSIS IN DISEASES OF THE 
LUNGS AND HEART. 
I will not speak of the therapeutical applications of veratrum 
viride in consumption, for from the indications already detailed for 
its use, its value in the general treatment may be readily inferred. 
In the diagnosis of the meagre and subtle signs, by which this 
insidious disease first makes known its approaches, I have found 
veratrum viride to afford me the most essential service, rendering 
clear and easily recognizable signs which, without the previous 
preparation of the patient by this remedy, were obscure and of 
difficult diagnosis. 
When the tubercular deposits have made large encroachments 
upon the lung, and loud mucous rales betray the existence of a 
cavity, there is no difficulty in making a diagnosis that at this stage 
must be synonymous with a fatal prognosis. 
But without the previous preparation of the patient, by this 
remedy, the prolonged expiration, faint crepitation, or slight harsh- 
ness of respiration, the frequent complications of functional disturb- 
ance of the heart, the extent to which its sounds may be heard and 
its murmurs mask the true signs from the lungs, or other causes 
tending to obscure the respiratory murmurs, exercise a most per- 
plexing influence, and prevent or render difficult a clear diagnosis 
at precisely that stage, when treatment may reasonably be expected 
to be of some avail. It is these early signs that are likely to 
escape detection, to be overlooked or rendered obscure, and great 
caution needs to be exercised to discriminate between functional 
disturbance and organic lesions. 
To properly discriminate these differences, I have, for several 
years, been in the habit of preparing my patient, whose heart or 
lungs I wished to examine, by the administration of small but fre- 
quently repeated doses of veratrum viride, and have thus been 56 
PRIZE ESSAY: 
enabled to easily attain a certain knowledge of the signs of the 
disease at an early period, when, without this preparation, a correct 
diagnosis could be arrived at only with great trouble and most 
patient investigation. 
It will be found of inestimable advantage in the diagnosis fre- 
quently required by Life Insurance Corn-panics. I have before men- 
tioned it as a means of diagnosis in pneumonia and valvular 
disease of the heart. (See Cases 2, 5, 10.) 
T. Cs(J As/*/ /ty //t / L< c f 
DIVISION THIRD. 
THERAPEUTIC APPLICATION OF THE RESINOID OF VERATRUM VIRIDE. 
Case 1. Surgical Fever. J. B., aet. 84 years. A stout muscular 
mechanic, upon whom a surgical operation had been performed 
for the removal of a large tumor. As reaction came on he became 
exceedingly uncomfortable, with all the symptoms of surgical fever. 
The fever commenced soon after my morning visit, and as I was 
not informed of it, I did not see him again till the next morning. 
The pulse was then 165, and the respirations 30. I commenced 
the use of the resinoid tincture of veratrum viride alone. 
Date. 
Pulse. 
Respira- 
tions. 
Treatment. 
June 19th, 10 A. M. 
165 
30 
Resin, tr. ver. vir. 
tRv. 
11 “ 
160 
30 
66 66 
RUv. 
12 “ 
162 
30 
66 66 
Rlv. 
1 P. M. 
147 
29 
66 66 
•nliij. 
2 “ 
138 
26 
66 66 
Ttliij- 
3 “ 
125 
25 
66 66 
lRiv. 
4 “ 
97 
24 
t< 66 
miij. 
5 “ 
95 
25 
66 66 
TRiv. 
6 “ 
79 
20 
66 66 
Ttliij. 
7 « 
71 
20 
66 66 
Rlh'j. 
9 “ 
64 
20 
66 66 
Rliij. 
11 “ 
65 
20 
66 66 
niij- 
20th, 1 A. M. 
64 
20 
66 66 
Ttliij. 
5 “ 
76 
20 
66 66 
1RV. 
8 “ 
72 
20 
66 66 
TRV. 
10 “ 
63 
20 
66 66 
Rlhj. 
12 “ 
64 
21 
6 6 66 
TRiv. 
4 P.M. 
68 
20 
66 66 
■njiv. 
7 “ 
64 
20 
66 66 
liliij. 
From this time he was left in charge of his friends, with directions 
to give him four minims of the resinoid tincture every four hours; 
this treatment was continued for three days longer, during which 
time the pulse did not rise above 75 in the minute. There were 
no unpleasant symptoms afterwards. 57 
PROPERTIES OF VERATRUM VIRIDE. 
Case 2. Pleuritis. Mrs. N. R. When I first saw this patient, 
she had acute pleurisy of the left side. 
Time. 
Pulse. 
Treatment. 
11 A.M. 
132 
Resin, tr. ver. vir iRv. 
12 “ 
130 
“ “ TT^V. 
1 P. M. 
121 
“ “ iRv. 
2 “ 
120 
“ “ Pliv. 
3 “ 
98 
“ “ TT^iv. 
4 “ 
96 
“ “ Pliv. 
5 “ 
92 
“ “ 
6 “ 
72 
7 “ 
60 
“ “ mij- 
8 “ 
54 
At 8-J o’clock she attempted to get out of bed, but the moment 
she rose up she was seized with nausea, and fainted. Upon re- 
covering from the fainting fit she vomited twice, and then lay 
back in bed in a quiet dreamy state. At 11 o’clock the pulse had 
risen to 62. 
Three minims of the resin tincture were continued every two 
hours until 7 P. M. of the next day, when she was entirely well and 
free from pain. 
Case 3. Acute Bronchitis. I was called to see a young man set. 
22, suffering with extreme dyspnoea. He was propped up in bed, 
and endeavoring to gain some relief by breathing the vapor from 
a pitcher of boiling water. The efforts at respiration were painful 
to witness, and the expression of the face and the position assumed 
were indicative of extreme suffering. He could speak but a few 
words at a time, but begged me earnestly to give him quick relief, 
or he should die of suffocation. 
Upon percussion I found the chest resonant, but upon listening 
I could hear no vesicular respiration; the air entered the lungs 
slowly, and seemed to leave them more slowly and with effort, 
causing a harsh sibilant sound. There was much fever, with a 
small, frequent, irritative pulse, which could not be counted. 
I gave five minims of the resin tincture of veratrum viride, and 
repeated the dose every hour until four doses had been given. 
Before the third dose had been given, the pulse could be counted 
138 in the minute, and after the administration of the fourth dose 
it was 129. 
The same dose was continued at intervals of two hours, and the 
respirations gradually became fuller and less labored. He could 58 
prize essay: 
not lie down, but slept considerably while propped up in bed 
during the night. The same dose was continued at intervals of 
two and a half hours through the next day with very marked 
relief, so that he could with high pillows lie down comfortably. 
This dose kept the pulse at between 80 and 90 beats, but produced 
no vomiting. 
On the evening of this day slight crepitation could be heard in 
many spots, and the next day crepitation could be heard over the 
whole lungs, and there was slight expectoration. 
The remedy was continued at longer intervals, and on the eighth 
day he was out attending to business. 
Veratrum viride is, probably, more serviceable in cases of acute 
bronchitis than in any other disease. Tn nearly all instances it 
entirely supersedes the necessity for venesection, in fact, it relieves 
the physician from all necessity for discussing the propriety of 
venesection. 
Its first effect alone, of lessening the rapidity of the circulation, 
does all in this inflammation of the mucous surfaces that could be 
effected by venesection, for by diminishing the quantity of blood 
sent to the lungs, arterialization can more fully take place, and the 
painful sense of suffocation is thereby relieved. 
As a sedative it relieves the painful dyspnoea, and as an expec- 
torant it removes the consequences of the inflammation. Venesec- 
tion produces debility, which, at times, in this disease cannot be 
recovered from, whereas veratrum viride produces no debility. 
Case 4. Delirium Tremens. During the last seven years, I have 
recorded in my note-book the results of the treatment of many 
cases of delirium tremens with veratrum viride. In thirteen cases 
of this disease the treatment was with resin tincture of veratrum 
viride alone. I have succeeded well with this treatment, and of 
these thirteen cases not one proved fatal. 
The plan of treatment has usually been to give four, five, or six 
minims every hour until the pulse was reduced to 60 or 70 beats 
in the minute, and until nausea was induced; then a smaller dose 
was continued at longer intervals. These are always troublesome 
cases that require frequent personal attention. 
In some of these cases the same treatment has been adopted un- 
til nausea and vomiting have been induced, then morphia in J gr. 
doses has been administered as often as found necessary, and have PROPERTIES OF VERATRUM VIRIDE. 
59 
produced a better effect than a grain of morphia would do without 
the previous preparation by veratrum. 
The veratrum is usually continued for several days in small 
doses. In two cases recorded it was continued for ten days after the 
delirium had ceased. It relieved the irritable state of the mucous 
membrane of the stomach, and restored the appetite. 
I have frequently relieved the uncomfortable feeling following a 
debauch by small and frequent doses of veratrum viride and bi- 
carbonate of potassa. 
I have found the resinoid tincture of veratrum viride of more 
service than any other medicinal preparation in producing that 
perfect relaxation so necessary in taxis for hernia, and in the pas- 
sage of a catheter for stricture. 
DIVISION FOURTH. 
GENERAL SYNOPSIS OF THE ALKALOID YERATRIA FROM VERATRUM 
VIRIDE. 
By reference to the second section of this monograph, it will be 
seen that the alkaloid veratria, obtained from veratrum viride, is 
identical in its chemical reactions to that obtained from veratrum 
album, and from veratrum sabadilla. 
By reference to the third division of the third section it will be 
seen that the physiological and therapeutic actions of the various 
alkaloids are very similar. 
In what particular principle of the plant, then, resides the differ- 
ence in the therapeutic action of the several species of this genus? 
We see, from the written history of veratrum album, for many 
centuries, that it differs in its physiological and therapeutic actions 
from veratrum viride. 
We observe from the few cases reported in the last division1 
that the resinoid principle of the plant possesses nearly the same 
physiological and therapeutical action as the whole plant, and that, 
therefore, the medicinal action of the plant is due more to the 
several resinoid principles, which exist in considerable quantities, 
than to the alkaloid, which exists in a very small quantity. 
If the amount of alkaloid alone, which we obtain from a given 
quantity of the tincture, was dissolved in an equal amount of men- 
1 A very large number of cases might have been added to this division, but I 
feared that by giving more I should make the work prolix. 60 
prize essay: 
struum to which it exists in the tincture, we should that the 
small dose administered would produce no noticeable impression. 
It is probable, however, that all alkaloids exist, in a natural com- 
bination, in larger proportions than we obtain them by chemical 
means ; but if this one existed in double the quantity obtained by 
isolation, it would still be insufficient, in the small doses that are 
given, to produce the effects that are noticed by proper medicinal 
doses. 
We have in other medicinal agents alkaloids, which, when in 
combination with the whole medicinal virtues of the plant, exer- 
cise but little influence, but when isolated and given in full doses 
differ from the action of the entire virtues of the plant. 
Aconitina and codeia may be mentioned as examples. We see 
as much difference in action between veratrum and veratria. 
When given in doses sufficient to produce a noticeable effect, it does; 
to some extent, act as a direct sedative to the heart, but it does not 
act uniformly in this manner, as the tincture of the root or the 
resinoid does; it has a more mixed action upon the heart—an action 
somewhat resembling the effect of aconitina, and this is frequently 
an irritant action, and is more plainly noticed if given in large doses. 
The pulse, by full doses of veratria, is first depressed, but after- 
ward the irritant action follows and the pulse increases in fre- 
quency, and this, as we have seen in the cases mentioned, is not 
the action of the tincture of the plant, nor the resinoid. 
The question then seems to be settled, that the alkaloid is not 
essential to the complete sedative action of the plant, and that the 
resinoid principle, entirely freed from the alkaloid, is equally reli- 
able, as an arterial sedative, as the tincture made directly from the 
root. 
Of the external uses of the alkaloid I do not feel that I have 
sufficiently elaborated it to speak at present. 
1 have used it many times, but prefer the alcoholic extract of 
the plant mixed with glycerine. I have not, with either, met with 
the same success that Turnbull relates. 61 
PROPERTIES OF VERATRUM VIRIDE. 
SECTION FIFTH. 
SUMMARY OF THE PHYSIOLOGICAL AND THERAPEUTIC 
ACTION OF YERATRUM VIRIDE ON MAN. 
DIVISION FIRST. 
GENERAL ACTION. 
The following observations are given as the results of a very 
large number of experiments and therapeutical applications, but it 
is unnecessary to relate these in detail, as I have done in giving 
my experiments on animals, and in cases of various diseases in the 
human subject. 
The true therapeutic properties of veratrum viride were not un- 
derstood before Professor Tully’s investigations, and Dr. Osgood’s 
publication ; nearly all who wrote on it before that time classed it 
with its European congener, and used it chiefly in chronic com- 
plaints. 
Dr. Osgood pointed out a class of diseases in which it seemed to 
produce the same general effects as the veratrum album, but with 
more certainty and greater safety; but he demonstrated also that, 
though it was alike in some of its effects, it differed very materially 
in others. 
One of the characteristic effects of veratrum album is the uncon- 
trollable purging it frequently produces if given in full doses, 
causing whitish, frothy, abundant, and frequently bloody evacua- 
tions, which leave the alvine canal in an irritable condition. On 
the contrary, veratrum viride produces no purgative effects when 
given in medicinal doses by the mouth. 
Dr. John Ware, of Boston, administered it in thirty cases, and in 
not one was it clear that purging was produced. Such is the testi- 
mony also of Osgood, Norwood, Frost, and many others who have 
used it freely. I have carefully watched over one thousand cases 
for this effect, and I have never seen a case in which I was satisfied 
that purging was produced by this alone, when given by the mouth, 62 
prize essay: 
but I have seen several cases of constipation depending upon an 
inflamed or irritable condition of the intestines, relieved by it in 
somewhat the same way that sedatives or opium will relieve these 
cases. I have frequently used it in inflammatory states of the sys- 
tem, as an adjunct to a purgative, to overcome the irritability of 
the muscular fibre of the intestines, and to quiet arterial excitement. 
In this way it assists purgative medicines, and causes their more 
rapid action. It was in this way that it was used in the old secret 
remedy called “ Coit’s pills.” 
peculiar and characteristic effect of veratrum viride is its 
action upon the pulse. It is a reliable and powerful arterial seda- 
tive. With it the force and frequency of the pulse can be controlled 
almost at will. 
I have frequently found the pulse that was too fast to count— 
irritable and thready—reduced in the course of a few hours, by 
moderate doses, to 70 beats in the minute, and by larger and more 
frequently repeated doses to 40 or 35 beats in the minute, and that 
with no danger to the patient, for when the remedy was discon- 
tinued, the pulse gradually regained its healthy beat, provided the 
remedy had been used long enough to subdue the inflammation. 
It lessens both vascular and nervous action, and at the same 
time relaxes the muscular system, and renders the respirations easier 
and somewhat slower. It is particularly applicable where there 
is a great excess of arterial and nervous excitement on account of 
some sudden or acute disorder without any great depression of the 
vital powers, in sthenic inflammations generally, and surgical fevers, 
and especially those that are sudden and quick in their course, and 
require to be arrested promptly and quickly. 
It is, if possible, more serviceable to the surgeon than to the 
physician, for in those cases of surgical or traumatic fever, result- 
ing from operations or injuries, its specific effect in arresting arterial 
and nervous excitement is particularly required, and its effects in 
quieting and reducing the pulse, and keepiug it at or below the 
healthy standard, until the cause of the excitement subsides, or is 
removed, frequently prevents serious results. 
After operations upon the arteries for aneurisms or other diseases, 
the action of the heart can be lessened or controlled, and by this 
means secondary hemorrhage may be prevented. Too great vas- 
cular excitement, and a derangement of the circulation, resulting 
from the obliteration of large arteries, frequently supervenes after 
operations, preventing a healthy restorative process from going on. 63 
PROPERTIES OF VERATRUM VIRIDE. 
Any means which will control this excitement without the neces- 
sity of bleeding (which generally weakens the patient, and thus 
retards recovery) will assist in the recovery by subduing irritation, 
and by allowing the system gradually to regain its energies, and 
accommodate itself to its new relations. 
This remedy, in these instances, produces but a transient effect, 
but may prevent lasting injuries, and prove of permanent benefit 
by relieving temporary exigencies. 
It is also an invaluable assistant in the diagnosis of cases of dis- 
ease of the heart or lungs. 
In a great many instances in which this medicine is indicated, 
but one simple rule is necessary in its administration, viz: increase 
or diminish the dose according to the state of the pulse. 
If it is necessary at the outset of a disease to reduce the pulse 
from 150 to 60 beats in the minute, and keep it at that number for 
several hours, give the remedy in as full doses as the patient will 
bear without disturbance to the stomach, and repeat it at short 
intervals until the object is attained; the dose can then be given 
at intervals of three or four hours, according to the state of the 
pulse. 
There are instances in which a prompt arterial sedative is re- 
quired, and in which vomiting will do no injury; in such cases it 
may be given in full doses of three or four minims, and at intervals 
of half an hour, until vomiting is induced; the pulse will frequently, 
in such instances, sink lower than required, occasionally as low as 
50, 40, or 30 beats in the minute: this need occasion no alarm, for 
it is only necessary to suspend the use of the remedy for some 
time, and not begin its use again until the pulse returns to the 
point at which it is intended to keep it. To obviate any unpleasant 
effects, the medicine may then be resumed in small doses, and 
repeated at longer or shorter intervals, according to the influence 
it exerts upon the pulse. 
If it is desirable to induce vomiting, let warm diluents accom- 
pany the remedy, but should it be necessary to avoid it, give the 
patient no more fluid than is absolutely required, and administer 
the medicine in small and frequent doses, carefully watching the 
pulse. But do not be deceived in the state of the pulse; recollect 
that position will have a great influence, and if the pulse be found 
at 60 while recumbent, it will be found at 65 or 70 a few minutes 
afterwards, if the patient should be in a sitting position, and in a 64 
PRIZE ESSAY: 
standing position at 75; and for a short time after the change of 
position the pulse will have a different character. 
In the recumbent position the force of the pulse is always great- 
est, and the frequency the least, so that we have the greatest 
strength and the least frequency at the same time. Faintness may 
be induced if the pulse is reduced too much while in a recumbent 
posture,.and the patient be allowed suddenly to stand up; in fact 
while under the influence of this medicine the patient should not 
be permitted to change his position suddenly. Let then the posi- 
tion be the same at the different times of examining the pulse, or 
make due allowance for the change. 
Even in health sleep has a marked influence upon the pulse, and 
during the administration of this medicine, sleep produces a great 
change. I have found the pulse to fall 20 beats in the minute with- 
in a quarter of an hour, merely from the patient falling asleep. In 
such cases the respirations become slower and full, the pulse loses 
its irritability, becoming soft, full, and easily compressible; ,the 
secretion from the skin is very abundant, becoming cold and 
clammy if there has been much nausea or prostration. 
In this state there will be no difficulty in arousing the patient, 
as there is when narcotics have been administered. 
DIVISION SECOND. 
ITS ACTION ON THE VASCULAR SYSTEM. 
Veratrum viride exerts a sedative influence upon the vascular 
system. In whatever medicinal doses it is administered it regulates 
the force and frequency of the pulse. Whether it is given to the 
chlorotic female, with a pulse of 120, thin, wiry, and irritable, or 
to the threatened apoplectic, with a full and bounding pulse, or in 
fatty degeneration of the heart, where the pulse is slow, easily 
compressible, wanting in tone, it alike regulates the force and fre- 
quency of the pulse, and exerts a sedative influence on the heart’s 
action, bringing it by proper doses to the normal and healthy 
standard. 
If the dose administered be small and frequently repeated, the 
pulse may be reduced from 120 to 80 beats in the minute; if a 
larger dose be given it may be reduced to 50, but it does not be- 
come irregular or intermittent, unless the remedy is pushed beyond 
the point of propriety. PROPERTIES OF VERATRUM VIRIDE. 
65 
In poisonous doses the pulse loses its rhythm and strength, 
becoming very slow and compressible, sometimes allowing an inter- 
mission of several seconds to pass. It is unlike aconite in its 
effects, for, to a certain point, aconite reduces the irritability and fre- 
quency of the pulse; but if the dose be pushed beyond this point, 
the pulse becomes small and weak, but more frequent. I have 
several times seen the pulse quickly increased from 80 to 120 by 
an increased quantity of aconite; but I have never seen the same 
effects from veratrum viride. 
With most other remedies, when the heart’s pulsations have 
decreased in intensity, there seems to be an effort at compensation, 
and they cause an increase in frequency of its pulsations. This is 
not the case with veratrum viride in medicinal doses, for the heart 
seems unable to acquire intensity, and is too thoroughly subdued 
to attempt the compensative effort of frequency. As it decreases in 
frequency it increases in fulness and regularity, and we find that 
the patient does not lose strength, but gains tranquillity. 
In poisoning by this agent there is a labored effort of the heart; 
the pulsations are sometimes increased in frequency, and are inter- 
mittent, and found to vary every few minutes. 
Whether in all primary inflammations it is a mere reduction of 
the frequency of the circulation and of nervous excitement that is 
needed, or an actual change in the character of the blood as well, 
it is not my province to discuss at this time, but every one’s ex- 
perience must give him some evidence on this point. 
We have seen and shall find hereafter in the experiments per- 
formed for this purpose, that this medicine exerts an action on the 
blood, and that action is of an antiphlogistic character, because it 
alters the blood by elimination; but does it act as some of the 
saline medicines do as a solvent of fibrin, either while within the 
veins or out of the body? 
It has been demonstrated by Simon, and confirmed by Bird and 
others, that tartarized antimony and many of the salines have the 
power of diminishing the amount of fibrin in the blood, and by 
this means relieve the tendency to inflammation. Yeratrum viride 
has not the power of dissolving fibrin when out of the body, nor 
does it produce the effects of antimony and salines upon the blood 
within the veins, by diminishing its plasticity and rendering it 
liquid and incoagulable. 
Its action is principally a vascular sedative, producing, as we 
shall see, a change in the blood itself, and a peculiar effect upon 66 
prize essay: 
the heart, arteries, and veins. I have taken a small quantity of 
blood from a person of full habit, laboring under a mild attack of 
pneumonia, and who had been for twenty-four hours fully and 
decidedly under the influence of veratrum viride, with a pulse at 
50. The blood coagulated and had a tolerably healthy appear- 
ance. 
This would not be conclusive proof, because in diseases of an 
inflammatory character the amount of fibrin in the blood is in- 
creased; I repeated this experiment, therefore, upon dogs in health, 
the results of which may be seen in Experiments XXIII., XXIY. 
In the 4th Section of this work we have given many instances 
of the therapeutic uses of the plant; but we have also given in- 
stances where it was of inestimable value as a means of diagnosis, 
and where organic lesions of the vascular system were readily 
detected while the patient was under the influence of the medicine, 
that could not be definitely diagnosed, or at least, could be discri- 
minated only with great difficulty from functional disturbances 
without preparing the patient by this remedy. 
By the assistance of veratrum viride we have in many instances 
been enabled with ease definitely to determine between organic 
and functional disturbance of the heart. There are instances in 
which it would be of value as a means of diagnosis in aneurisms. 
Though this is the best, I do not claim that it is the only sedative 
that can be used for its diagnostic properties; digitalis, tartarized 
antimony, and others may be used, but I am not aware that any of 
these remedies were resorted to for such purposes previous to my 
recommendation. 
DIVISION THIRD. 
ITS ACTION ON THE RESPIRATORY SYSTEM. 
The action of veratrum viride on the respiratory system is 
secondary to that on the vascular and nervous system. It reduces 
the frequency of the respirations somewhat in proportion to the 
effect it has upon the circulation, and not always in proportion to 
the dose administered. 
Where the circulation has been very rapid, and the respirations 
consequently frequent, we find that as the circulation becomes 
more normal, the respirations decrease in frequency; but, unlike 
opium, this remedy does not reduce the respirations much below PROPERTIES OF VERATRUM VIRIDE. 
67 
the normal standard. Its effect is sedative, not narcotic, on the 
respiratory nerves. Thus it is expectorant, increasing the secre- 
tion from the pulmonary mucous membrane; first, by its action 
upon the blood and bloodvessels; and secondly, by lessening or 
subduing irritability of the lungs. 
Owing to the diminished circulation and respiration, the tem- 
perature of the body is decreased while under the full influence of 
the veratrum. 
As a means of diagnosis in pneumonia, bronchitis, pleuritis, and in 
incipient phthisis, I have spoken fully in Section Fourth. 
DIVISION FOURTH. 
ITS ACTION ON THE NERVOUS SYSTEM. 
Veratrum viride exerts a sedative effect upon the nervous sys- 
tem, but whether it produces its primary effect upon the vascular 
or the nervous system, we will consider when we discuss its 
modus operandi. 
In medicinal doses it simply allays, controls or deranges nervous 
influences, but in poisoning doses it destroys them. 
Though it seems to exert but little action upon the mind, it 
makes the individual languid, quiet, disposed to sleep, and un- 
willing to be disturbed; and this effect is marked where it has 
been given in small and frequently repeated doses, controlling the 
heart’s action, without producing nausea and vomiting; but it is 
most noticeable where it has been taken in large and poisonous 
doses. 
These effects succeed its emetic action. Even in these cases the 
mind is clear, or but little confused ; and although by diminishing 
the rapidity of the suppty of blood to the brain, it produces vertigo, 
especially on moving, it seldom causes headache. In full doses it 
undoubtedly diminishes sensibility, but I have never noticed any 
marked impairment of either sight or hearing when administered 
to man. In animals I have noticed both. 
Its effects upon the brain temporarily resemble those produced 
by loss of blood, and they are undoubtedly produced by the 
sedative action on the circulation. Under the full influence of the 
medicine a change of position will produce vertigo or even syncope. 
It frequently induces sleep; not by any narcotic action, but by 
elieving congestion, irritability, and pain. 68 
PRIZE ESSAY: 
DIVISION FIFTH. 
ITS ACTION ON THE MUSCULAR SYSTEM. 
In moderate doses veratrum viride produces a relaxation of the 
muscles, and in fuller doses, a feeling of weakness and prostration. 
This effect soon passes off, and with a return of the normal circula- 
tion there is a return of muscular strength; it produces prostration 
rather than exhaustion. 
We have before stated, when treating of its physiological action 
on animals, that in full doses it paralyzes both the voluntary and 
involuntary muscles, and in those cases where death is caused by 
it, the fatal result is produced by paralysis of the heart’s action. 
One of the most remarkable effects of its action, in poisoning doses, 
is that the muscles have so lost their contractile power that they 
do not act well under the stimulus of galvanism. 
This loss of power of the muscular system, and its subsequent 
results upon animals poisoned by veratrum, I noticed some years 
ago. During a series of investigations upon veratria, obtained from 
veratrum album, and from veratrum viride, I noticed that ani- 
mals poisoned with the alkaloid from either plant lost all power 
over the locomotive muscles, and that the galvanic current did not 
exercise the same convulsive movements after death from this as 
it did in cases where death was produced from other causes. 
It has been asserted that this remedy always causes dilatation of 
the pupils. Such is not my experience; it does sometimes dilate, 
but generally it merely fixes the pupil, giving it the appearance of 
dilatation because it is kept in the centre, without motion, owing 
to the loss of power in the recti muscles. 
DIVISION SIXTH. 
ITS ACTION ON THE SECERNING SYSTEM. 
Veratrum viride exerts a very marked influence on the secreting 
organs. It augments the secretion from the pulmonary mucous 
membrane, and increases the expectoration in the first, second, and 
even third degree of its operation, but in the fourth degree there is 
no longer power to expectorate, so that the increased secretion is 
an additional source of danger. PROPERTIES OF VERATRUM VIRIDE. 
69 
Upon the urinary secretion I have not been able to satisfy my- 
self that, in health, it either diminishes or augments the quantity. 
As the amount of the secretion differs so greatly at different times, 
and under different circumstances, a long series of close observa- 
tions would be necessary to decide upon its effects. 
In cases of dropsies, resulting from obstructed portal or cardiac} 
circulation, with a frequent and irritable pulse, there is no article 
in the materia medica that produces so copious a discharge of urine. 
But this is a mere secondary effect, caused by subduing the heart’s 
labored action. As the congestion is lessened, the kidneys carry 
off the excess of serum, and absorption of that already deposited 
takes place. In most cases of disease it increases the specific gravity 
of the urine. (See Cases 2 and 5.) 
But the chief secerning effect of veratrum viride is upon the 
skin. In whatever doses it is taken its effects are plainly manifest. 
In small doses it produces a pleasant comfortable moisture, but in 
large doses the diaphoresis is free and abundant, the perspiration 
standing in large drops upon the brow and face. If full doses of 
the remedy are given, and the person is warmly covered, the dia- 
phoresis is free, and the skin feels moist and comfortable, but any 
portion of the skin which is left uncovered is bathed in a cold, 
abundant, clammy sweat. And herein is one of its most valuable uses, 
for in some cases of fever, where the skin is harsh and dry, a favor- 
able crisis may be produced by causing an abundant diaphoresis. 
It early acts as a sialagogue, freely increasing the secretion of 
saliva. It should not be forgotten that amongst the functions of 
the salivary glands the rapid and copious elimination of fluid that 
takes place, especially if abnormally excited, does much towards 
relieving the congested state of the vessels; and its secondary effects, 
in promoting the absorption going on in the stomach, assists the 
ultimate removal of a large quantity of fluid by the kidneys. 
By these effects, as well as its effects upon the circulation, vera- 
trum viride is a true antiphlogistic. By its rapid eliminative ac- 
tion on the glandular system, it causes absorption and disappear- 
ance of glandular enlargements. 
I have discovered traces of its active principle in the urine, but 
I do not, on that account, conceive it to be diuretic, but that its 
diuretic effect is owing to diminished pressure upon the vascular 
system. Digitalis acts as a diuretic in the same way. 
When the alkaloid veratria was administered to dogs, either by 
hypodermic injection or by the stomach, the alkaloid was several 70 
prize essay: 
times detected in the urine, and the urine produced also the same 
physiological results when administered to other animals. (See Ex- 
periments IX., X., XI.) 
It was also detected in the milk of a nursing woman (see Case 
No. 6), and under the use of the medicine the inflammation subsided. 
Induration of the lymphatic glands is also relieved by it. 
DIVISION SEVENTH. 
ITS ACTION ON THE ALIMENTARY CANAL. 
Veratrum viride increases the secretion of mucus from the 
stomach and intestines, and by its nauseating effects produces a 
continuous sympathetic action on the liver and pancreas. It has 
no cathartic nor aperient effect upon the bowels when taken by the 
mouth; but as it lessens congestion and irritability, constipation is 
frequently relieved by its use. 
When injected into the cellular tissue we see that it does act as 
a cathartic (see Expts. IV. and V. of Div. 2d). In plethoric constitu- 
tions it forms an admirable adjunct to purgatives. The veratrum 
album, on the other hand, does act as a purgative when taken by 
the mouth as well as when injected into a vein or the cellular tissue. 
DIVISION EIGHTH. 
EMETIC ACTION. 
Tn full doses, 10 to 15 minims of the concentrated tincture, be- 
fore described, it produces vomiting, and by the first act of vomit- 
ing the contents of the stomach are sometimes thrown off without 
much preceding nausea, the stomach alone seeming to contract 
upon its contents, and the abdominal muscles and diaphragm re- 
maining comparatively passive. 
But the vomiting most usually produced by veratrum viride is 
preceded by nausea, prostration, a marked diminution in the fre- 
quency of the pulse, and paleness of the face and lips. 
If vomiting from the use of this agent continues long, it fre- 
quently becomes spasmodic, and much bile is thrown off, owing to 
the extension of reflex action to the duodenum and liver; and 
when bile is thrown off there is more protracted vomiting, more 
painful nausea, and general prostration. 
If the dose be large its effects as an emetic will be certain, strong, PROPERTIES OF VERATRUM VIRIDE. 
71 
and permanent, and will make a powerful impression on the sys- 
tem. As an emetic it should be used only in those cases where 
the pulse is strong and full, or where there is phlogistic action; it 
would be unwise to administer it for its emetic effect where the 
patient was feeble or deficient in either nervous or vital force. 
Above all, it should not be given for its emetic effect where there is 
a natural liability to syncope, or where there is disease of the heart. 
If the remedy be given in overdoses, the effects described by 
Osgood are, vomiting, followed by “ much ineffectual retching, 
almost constant hiccough, chilliness, dimness of sight, vertigo, ina- 
bility to control the voluntary muscles, distress of the stomach, 
pulse small and creeping.” I have seen all these effects from acci- 
dental poisoning with this article, but I have never seen such effects 
when administered in medicinal doses. 
If it be necessary to avoid vomiting, and the stomach is sour 
and irritable, give a little bicarbonate of soda, magnesia, or other 
alkali; it is necessary to lay much stress upon this, for if the sto- 
mach be in an irritable condition, the veratrum will act too harshly, 
unless checked by the previous administration of the alkali. 
When it is necessary to give the remedy as freely as the patient 
will bear it, to produce its sedative effect upon the circulation and 
upon the nervous system, it is well never to omit to learn the con- 
dition of - the stomach, and if there is gastric irritation it should be 
controlled by soda and hyoscyamus, or morphia, that emesis may 
not be produced. 
Although its emetic effects are exceedingly valuable in control- 
ling acute inflammations, such as ophthalmia, gonorrhoea, and croup, 
and severe nervous affections, or fevers of a high grade, it is not the 
depressing effects of nausea which cause the reduction of the force 
of the circulation; for I have with this agent reduced the pulse to 
30 beats in the minute, without causing the slightest nausea; and 
we almost always see a reduction in the number as well as the 
character of the pulsations before nausea is induced, and especially 
where it is given in full doses for the purpose of producing vomit- 
ing. And vomiting frequently takes place without any precur- 
sory feelings of nausea, but not before the effects of the medicine 
are plainly felt upon the pulse. 
It seldom acts as an emetic except in very large doses, in less 
than three-quarters of an hour, and sometimes not before one or 
two hours, but its effects upon the pulse are sometimes distinctly 
felt in fifteen minutes after its administration, and they are thus 72 
prize essay: 
early noticed not so much in the reduction of the frequency of the 
pulsations as in the greater softness of the beat, and the lessening 
of its nervous, irritative character. This will be apparent by re- 
ferring to those cases previously reported, in which the medicine 
was administered by injection into the veins. 
When the stomach has once been emptied of its contents by an 
emetic dose of veratrum, the fluid that is afterward vomited is pecu- 
liar, and unlike other fluid that is thrown up from the effects of any 
other medicine with which I am acquainted. It is a viscid, ropy, 
semifluid mass, having much the appearance of the white of egg 
mixed with a portion of the yelk, but not so deep in color as if the 
whole of the yelk had been mixed with the albumen. Occasionally 
the vomited matter is an opaque yellow, but it is generally trans- 
parent ; sometimes it looks exactly like egg in a state of decompo- 
sition. It has the same peculiarity, whether vomited by human 
beings or dogs or cats. 
Objections have been raised by some persons as to the pure 
sedative character of this medicine, because it produces an emetic 
action. The objection is not tenable, as other sedatives, as tartar 
emetic, produce a like effect, and nearly all derange the action of 
the vagus nerve. 
Norwood is in error when he says ‘'it is a certain and valuable 
emeticit is certainly a powerful and alarming one. 
DIVISION NINTH. 
RECAPITULATION. FIRST, SECOND, THIRD, AND FOURTH DEGREES OF 
OPERATION. 
First Degree of Operation.—If two minims of the concentrated 
tincture are administered to an adult; its effects are scarcely per- 
ceptible in any way for less than an hour; its effects will then be 
noticed by a diminution in the force of the pulse, which will gradu- 
ally become softer. No symptoms that are perceptible to the 
patient will be felt from one small dose; but if the same dose be 
repeated an hour after the administration of the first, and so con- 
tinued for three or four consecutive hours, there will be a marked 
diminution in the frequency of the pulse, together with diaphoresis 
and increased flow of saliva. Doses of this quantity administered 
hourly for four or five hours, will frequently cause the pulse to 
fall from 150 to 90 or 80 beats in the minute, and the respirations 
will become fuller and less frequent. PROPERTIES OF VEEATEUM VIRIDE. 
73 
Second Degree of Operation.—If a dose of five minims of concen- 
trated tincture be given every hour, vomiting will generally be 
produced before the fourth hour, and frequently before the third. 
The first vomiting is usually very easy; sometimes not preceded 
by nausea, and sometimes the nausea occurring only a few minutes 
before vomiting. At other times the nausea is felt early, and is 
persistent for several hours before vomiting takes place. 
The pulse by the third or fourth hour will frequently be re- 
duced tq 60 beats in the minute ; and if the remedy is now con- 
tinued in diminished doses, at rather longer intervals, the pulse 
may be kept at this state as long as desired. 
The patient continues to express a feeling of nausea if he 
attempts to sit up; but if left undisturbed, is easy, drowsy, and in- 
clined to sleep, or at any rate to rest quietly. The mind is clear, 
but slow to take notice. 
The skin is covered with a clammy moisture upon parts of the 
body that are exposed, but if covered, the feeling is that of moist- 
ure, with a comfortable but lessened degree of heat of the skin. 
The secretion of saliva is free, sometimes viscid, with an in- 
creased secretion of bronchial mucus. The urine is augmented if 
there has been any preceding fever. 
Third Degree of Operation.—If the same dose of five minims is 
continued after vomiting at the same intervals, or if a large 
quantity is given too freely before vomiting, the pulse will be re- 
duced to 50 or 40 beats in the minute. 
The nausea will continue with an occasional eructation of a 
mouthful of viscid mucus, and if the remedy is not suspended there 
will be much retching and painful vomiting, with prsecordial dis- 
tress. The countenance will become pale, and the aspect alarming 
to the friends. 
If the patient assumes an erect position he will become faint. 
There is great muscular relaxation and feebleness, and sometimes 
dimness of vision. The respirations become uneasy and irregular. 
The surface of the body is wet, and where exposed quite cool. 
The mind is not disturbed, and the patient, if not frightened by 
the friends, will feel no alarm. 
If the remedy be suspended these symptoms will subside in 
three or four hours, and will entirely pass over in six hours. 
This state will occasionally be caused by exceedingly small 
doses in those who are very susceptible to its influence. 
Fourth Degree of Operation.—Where large doses have been given prize essay: 
by mistake, or where too large ones have been given at frequent 
intervals, and continued too long, there will be violent and con- 
tinued vomiting and retching, the countenance will become exceed- 
ingly pale and ghastly, the prostration will be great, and syncope 
will occur if the head is raised much above the horizontal position. 
The feelings are more those of prostration than pain; but some- 
times there is great praecordial distress. Sensation and consciousness 
remain, but are impaired, and there is depression of the mental 
power; the patient hears what is said, but is unwilling to answer 
questions, or to be disturbed in any way. Muscular action is im- 
paired, and the vision is dim. The voice is weak and the respira- 
tions slow. 
The pulsations are unfrequent, and sometimes irregular and 
intermittent, reduced to 30 beats in the minute, and in one instance 
related to me, to even 19 in the minute. The surface is cold, and 
bathed in a profuse clammy sweat. 
Patients, even in this state, recover more rapidly than would be 
supposed, if the proper remedies are administered, as it is a state 
of prostration, not of exhaustion. 
I have never seen nor heard of the death of a human being from 
veratrum viride; its poisonous effects on animals are described 
under their proper head. 
Many physicians have employed veratrum viride in moderate 
doses, and yet have produced the effects here described as resulting 
from its excessive use. 
The friends of the patient, greatly alarmed, have summoned the 
physician in haste, and unless he has seen such cases before, or is 
aware of the effects occasionally produced by this remedy, he is 
equally alarmed. 
I have heard of many such cases, and the physician has after- 
wards forsworn the use of the medicine, considering it one of 
extreme danger. This result will seldom happen, if it is given in 
small doses, and frequently repeated, watching the character and 
frequency of the pulse the while, and suspending or reducing the 
dose when necessary. But when it is given in full doses, and at 
longer intervals, and the character of the pulse not closely watched, 
the result before described will be produced. 
Although it has no cumulative effect, the first few doses some- 
times produce but little action, owing to a derangement of the 
stomach, or want of assimilation, but when absorption does once com- 
mence, the whole is taken up at once, and produces alarming effects. PROPERTIES OF VERATRUM VIRIDE. 
75 
It certainly is not a mark of wisdom to discard the use of a 
remedy, which has been proved to have such peculiar powers, 
simply, because in a few cases, which have been improperly watched, 
it has produced more serious effects than were either desired or 
expected. All remedial agents might be discarded on the same 
grounds. Such accidents should serve as lessons, and prove both 
the power and utility of the remedy, and the necessity of carefully 
watching every symptom of the patient. 
DIVISION TENTH. 
VERATRUM VIRIDE IN LARGE OR POISONOUS DOSES. 
There are several instances on record where veratrum viride 
has been taken in very large doses,1 two fluidounces and over of 
1 Is Veratrum Viride a Poison ?—We see in the May number of the Chicago Med- 
ical Examiner “ A case of poisoning and recovery from the use of Veratrum viride, 
by N. 0. Pearson, M. D.” 
We should hardly notice this isolated case were it not that many similar cases 
have been before reported, and in consequence some persons feel afraid to use the 
article in question. It will be noticed in this case that the patient took nearly 
seven minims of the tincture of veratrum every half hour until he had taken three 
doses in all, amounting to about twenty minims in 1| hour. The usual symp- 
toms of vomiting and prostration followed, with a pulse reduced to twenty-four in 
the minute, “full and intermitting every sixth or seventh beat.” The physician 
was alarmed, and administered opium in a “ most prodigal manner,” and his 
patient recovered. He says, “ This was a case of poisoning by veratrum viride, 
and should teach us to be very cautious in the use of so powerful a remedy.” We 
should undoubtedly be cautious in the use of every remedy, and should not ad- 
minister it in its full dose until we are most perfectly acquainted with its powers. 
We certainly differ in opinion with the author of this reported case ; and we feel 
perfectly assured that if he continues to administer his remedy as he recommends 
—“ until it produces a livid hue of the cheeks”—he will have many opportunities 
to cause himself and his patients more alarm than in the present instance. This 
“ livid hue of the cheeks,” of which he speaks, is but one of the symptoms of the 
full effects of the remedy, and indicates that it has been pushed to the point of 
prostration ; and no one will pretend for a moment to assert that it needs in all 
cases, or in a majority of cases in which its use is indicated, to be pushed to that 
extent. That point of producing “ a livid hue to the cheeks” is very seldom 
reached until vomiting is induced, or the usual nausea and paleness preceding 
vomiting, and in nine cases out of ten in which veratrum is indicated, we do not 
wish, in fact we wish to avoid vomiting. 
We think our friend has erred in the deductions he has drawn, and as he gets 
better acquainted with the therapeutic effects of his remedy, he will himself ac- 
knowledge so. Had he not administered opium, his patient would have recovered 
quite as well, as every one who has used the veratrum to any extent will assure 
him. We have several times induced just such a state, and purposely kept our 76 
prize essay: 
the concentrated tincture, but I have never met with a death from 
its action, nor have I ever seen a single authenticated case on record 
where death ensued from its use. 
Those cases, in which large doses have been taken, that have 
come under my observation, have been alarming from the excessive 
prostration produced; but they have been relieved by stimulating 
remedies, and within twenty-four hours the effects of the medicine 
have passed over. 
As a large dose taken at one time causes quick, free, and frequent 
vomiting, a great portion of it is necessarily ejected from the sto- 
mach, but a small dose frequently repeated is absorbed, and although 
it produces vomiting and retching, the prostration produced is 
patient at that point for the purpose of overcoming his disease, nor have we felt 
the least alarmed ; hut it is not frequently necessary to administer it in such doses. 
But in all cases where it is necessary to induce such a state, we carefully and fre- 
quently watch the pulse, and are guided in our doses by its action. 
But our principal object in bringing these cases before the notice of the profession 
is to elicit information, and we would ask, to what extent is veratrum viride a 
poison ? And if it produces death, in what manner does it do so ? It is not our 
intention at present to write a treatise on veratrum viride ; that we will leave till 
a future number, but we will give some few interesting cases, to show to what 
extent it has been taken. 
In the year 1823, a farmer of our acquaintance procured ten pounds of swamp 
hellebore, and boiled it in water down to a gallon of fluid for the purpose of wash- 
ing his calves to detroy vermin. His wife, who was sick at the time, and had 
some herb tea prepared, took in mistake a tumbler full of this hellebore decoction. 
It produced very alarming symptoms, vomited her very freely, and the prostration 
and cold sweat were fearful. By the ordinary stimulating remedies that were used 
she recovered in forty-eight hours. 
In 1840, a person of our acquaintance prepared two quarts of syrup, from what 
he supposed to be two pounds of American valerian, but a mistake was made, and 
American veratrum was used instead. A tumbler full of this syrup was taken at 
a dose, and as it caused vomiting the dose was repeated. The same alarming 
symptoms and prostration as before described followed, but in two days he was 
again able to be about. 
In 1858, a physician took, by mistake, thirty grains of veratrin (the combined 
medical principles of veratrum viride). It caused copious vomiting followed by 
prostration and loss of pulse at the wrist. By free use of brandy and warm ex- 
ternal applications he recovered, and was out again on the third day. 
A man, rather too fond of his neighbor’s rum bottle, went into a country store> 
and finding a bottle marked “Old Rum,” poured out and quickly drank nearly a 
tumbler full of tincture of veratrum viride. Not wishing the storekeeper to know 
of it, he said nothing about it until it caused vomiting, and then being much 
alarmed, told what he had done. A physician was sent for, rum was freely given, 
and the same night the man walked home. 
See also the North Western Medical and Surgical Journal, November, 1857, page 
493.—Amer. Journ. Indig. Mat. Medica, vol. i. p. 14. PROPERTIES OF VERATRUM VIRIDE. 
77 
greater in proportion than when the amount taken at one dose is 
larger. 
There is probably no remedy in the whole Materia Medica that 
produces such a death-like pallor. The effects produced upon the 
countenance much resemble the appearance caused by syncope 
from hemorrhage. 
In the cases and experiments that I have reported, of its action 
on animals, there are several deaths from its use by hypodermic 
injection, and injection into the veins, but when administered by 
the stomach, to cats and dogs, even in very large doses, they all 
recovered. 
As under its administration the secretions are augmented, it is 
rapidly carried out of the circulation, if the secreting organs are in 
a healthy state, free from organic disease. 
There is no question, I think, that in large doses, frequently 
repeated, or in cases where there is organic disease of the kidneys, 
it may prove fatal by its powerful sedative effect upon the circula- 
tion, causing syncope and cessation of the heart’s action. 
The treatment in cases of poisoning is a prompt stimulating 
plan. Hot spirits and water, tincture of cantharides, ammonia, 
electro-magnetism. The surface of the body, especially the extremi- 
ties, should be kept covered, and warm cloths applied. Friction is 
indispensable, as it keeps the blood in motion. Clear, undiluted 
spirits check the painful vomiting better than any other remedy. 
DIVISION ELEVENTH. 
CUMULATIVE ACTION. 
I have not met with any evidence that veratrum viride has a 
cumulative action; in fact I am satisfied that this so-called cumu- 
lative action seldom exists in any medicine, even digitalis. 
This action I have frequently seen with opium, occasionally with 
digitalis, hyoscyamus, veratrum, &c., but only in cases where there 
was disease of the kidneys; and wherever I have found this so- 
called cumulative action, I have afterwards found albumen in the 
urine. In albuminuria and urmmia, therefore, veratrum, like 
opium, is contra-indicated, except under the most careful watching. 
It does not, like antimony, possess the property of toleration. 78 
PRIZE ESSAY: 
SECTION SIXTH. 
MODUS OPERAND!. 
Yeratrum viride acts upon the system by transmission with the 
blood, and that its effects do not take place until after absorption 
into the blood is proved by:— 
1. Its peculiar action on the system when introduced elsewhere 
than into the stomach. 
2. The greater rapidity of its action, and intensity of its power, 
when introduced directly into an artery or vein. 
3. Its action on the various secerning organs, either when taken 
into the stomach, or when introduced into an artery or vein, a 
serous cavity, or the cellular structure. The presence of its alka- 
loid in the secretions formed out of the blood; when the extract 
of the plant was given by the mouth ; when it was introduced into 
a serous cavity ; or into the cellular structure beneath the skin. 
Also, the production of its physiological action when the milk, 
saliva, or urine of one animal to which the tincture has been for 
some time administered, is given to another animal. 
4. Its peculiar action upon the pneumogastric nerve when it 
reaches that nerve only through the circulation. 
5. The Absence of any impression conveyed to a distant part of 
the system when it is applied to the surface of the skin, together 
with the production of its topical effects to the nerves of the part 
to which it is applied, in proportion to the amount and rapidity of 
its absorption. 
6. The dilatation of the bloodvessels after its administration, 
visible by the microscope in the capillaries, and sensibly felt in the 
larger vessels by the slower passage and increased volume of the 
blood; and by the free diaphoresis produced. 
7. By its effects upon the blood disks, altering or diminishing 
their size. (See Section 3d, Division 4th.) 
Professor Christison asks of somewhat similar remedies, is the 
peculiar effect caused “ by being carried with the blood to the part PROPERTIES OF VERATRUM VIRIDE. 
79 
on which it acts, or by producing on the inner membrane of the 
vessels a peculiar impression which is conveyed along the nerves?” 
There may be objections raised to the 6th and 7th propositions, 
on the ground that if the bloodvessels are dilated and the blood 
disks rendered smaller, it is not explained how inflammation is 
relieved; and also why the red disks do not continue as before 
to flow through the capillaries which, in health, only carry the 
white globules ? It will be remembered that the flow of red blood 
through certain vessels only occurs in inflammatory conditions. 
In this inflammatory state the deranged flow may be partly owing 
to a vis-a-tergo, and an obstruction of the proper channels; or to 
an altered condition of the endangium of the particular part; or to 
an altered condition of the blood itself; all of which may be pro- 
duced by a deranged condition of the methaematous nerves of the 
part affected. 
After the administration of veratrum viride the blood is imme- 
diately acted upon, and it exerts a sedative effect on the endangium, 
and causes a dilatation of the vessels, so that the blocked-up cur- 
rent can flow in its proper channels. 
That it also exerts a powerful influence upon the vaso-motor 
nerves is proved by many experiments, and we have seen that 
when injected subcutaneously into one leg of a frog the cir- 
culation in the web of that foot was immediately stopped, while 
the circulation continued in the other foot for some time. It is 
also perhaps owing to a sedative action upon the excito-sensory 
nerves that it affords such rapid relief by hypodermic injection in 
some cases of acute neuralgia; for it has been demonstrated by 
Marshall Hall and Claude Bernard, that these nerves are not 
always distinct in their distribution, but run in company with 
other and larger branches of nerves. 
I need hardly repeat that this remedy is most successfully used 
in diseases in which there is an accelerated circulation, owing to 
inflammation or irritation. May not this diseased condition be 
relieved by the action of the medicine upon the endangium through 
the blood itself? 
This internal membrane of the vessels (membrana vasorum 
commure endangium1) is common to all the vessels of the circula- 
tory apparatus from the heart, to the smallest capillary. It is a 
very thin, transparent membrane, possessed of neither visible fibres, 
1 Burbach. ff. 698. Meigs, Diseases of Females, p. 342. 80 
PRIZE ESSAY: 
vessels, or nerves. It is easily torn, and its connection is severed 
by the application of a ligature to a vessel, but it is readily repro- 
duced. It is, in fact, almost, if not quite, the only channel or limi- 
tation for the circulation of the blood in the small capillaries, and 
as circulation is established in new formations, its growth keeps 
pace with the passage of the blood. As I have before said, it 
possesses neither visible fibres, vessels, or nerves, but is in itself 
one vast nervous communication, receiving healthy or diseased im- 
pressions from the blood, upon which it depends for the healthy 
performance of its functions. Like every other organ of the body 
it is formed from the blood, and when once formed it has special 
duties to perform, which duties are in part the communication of 
the proper nervous influences to the blood itself. It receives im- 
pressions from the blood, and in its turn communicates an action 
to the blood, and performs the finishing stroke in the transforma- 
tion of the living plasma. 
From observations on the use of this remedy, and from numer- 
ous experiments I have performed, it seems to me more than prob- 
able that it exerts its special and peculiar influence upon this 
endangium, or, as it might be designated, blood-nerve membrane. 
That its primary influence after absorption is upon this membrane, 
and that all of its other effects are owing to this influence; as the 
dilatation of the vessels; the contraction of the blood disks; the 
increase of secretion ; the resolution of congestion ; the loss of 
muscular power ; and paralysis of the heart’s action. The cause of 
death is syncope—cessation of the action of the heart, a paralysis of 
its muscular structure, owing to the inability of the blood to com- 
municate a continuous electro-tonic, or life force to the muscle. 
Dr. A. Billing, in his Principles of Medicine,x considers that all 
the medicines that have been called specifics, as mercury, arsenic, 
and colchicum, are not specifics, but that they owe their curative 
power to the capability of subduing different kinds of inflammation, 
or inflammatory poisoning, by causing contraction of the dilated 
capillary vessels. 
Mr. Wharton Jones, in his “Sir Astley Cooper Prize Essay,” 
states that medical solutions applied to the web of the frog’s foot 
produce very various effects upon the capillaries; and that sul- 
phate of copper, an irritant and astringent, has caused dilatation, 
while atropia, which causes such marked dilatation of some tissues, 
has in these cases produced contraction of the capillaries. 
1 Fiftli edition, pp. 70-75. PROPERTIES OF VERATRUM VIRIDE. 
81 
There are many who reason from these experiments of Mr. Jones, 
that the effects of medical agents upon the capillaries are not, and 
cannot be constant in their character. And yet in my opinion they 
are of no value whatever in deciding the effects of medicines upon 
the capillary circulation. They were applied externally only, and 
not internally, and their first effect would be on the nerves, not on 
the capillaries, and the effects described would be just such as might 
be expected when applied externally or not within the circulating 
fluid of the capillary itself. In the first instance an irritant, almost 
an escharotic, is applied to the surface, and it inflames the whole 
surrounding tissue, capillaries included, and as the primary effects 
pass off dilatation of the vessels affords relief to the part. In the 
latter case a powerful sedative is applied, and through its influence 
upon the peripheral nerves all the surrounding parts are fora while 
brought under its primary sedative influence; there is a lessened 
action, and less blood flows through the vessels of the part, nor 
am I aware that anybody has yet asserted that atropia causes 
dilatation of the capillaries; it is dilatation of some of the muscles, 
as the iris, that it is known to produce. This is one of its special 
actions, and we are every day improving in our knowledge of phy- 
siology, and of the action of medicines, by carefully noting these 
special actions of our various remedies. 
In these cases of Dr. Billing on the effects of mercury, &c., his 
observations were also no doubt made with great accuracy, the 
conclusions only which he has arrived at from these observations 
are not I think entered into with sufficient correctness. That there 
should be a dilated state of the capillaries in syphilis, lepra, and 
rheumatism, would seem more than probable as the poisons circu- 
lating in the blood would deteriorate its quality to such and extent 
as to cause a diseased and enfeebled condition of the endangium 
also, and thus produce a dilatation of the capillaries. But Dr. 
Billing does not speak of this dilatation as caused by a disordered 
condition of the blood, nor does he account for the subsequent 
contraction of the capillaries through an improved condition of the 
circulating fluid by a lessening of the amount, or an entire re- 
moval of the poison, but solely to the therapeutic and peculiar 
action of the mercury, arsenic, or colchicum. It appears to me that 
his observations are correct, but that his reasonings are erroneous. 
That peculiar poisons do so act as to cause contraction of the 
capillaries and even of the larger bloodvessels, we have sufficient 
proof in intermittent fever. In a paroxysm of this miasmatic 82 
PRIZE ESSAY: 
poisoning of the blood, the first symptoms are a chill and visible 
contraction of the external vessels of circulation; this lasts for some 
time; a fever then sets in, in which reaction takes place, and instead 
of a contracted condition of the vessels we have a state of dilatation, 
and the whole ends with an exudation from the vessels producing 
a copious perspiration, and then gradually the circulation returns 
to its normal state. Now that any medicine that would merely 
cause a dilatation of the capillaries in the first stage, or a contraction 
in the second, would cure the disease, I think improbable, unless 
at the same time it had a special catalytic effect. 
The antiphlogistic effects of mercury, arsenic, &c., are partly 
accorded by Dr. Billing to their capability of subduing different 
kinds of inflammation, or inflammatory poisoning, by causing con- 
traction of the dilated capillary vessels. But it is not even proved, 
it is as yet mere hypothesis, that there is dilatatiou of the capilla- 
ries in diseases that are cured by these remedies. There are also 
other remedies that are supposed to produce the same state of 
contraction, but which do not cure the diseases named. Other 
authors have assigned to the remedies in question a catalytic action, 
and in part attribute the cure of the diseases for which they are 
given to their antiplastic action on the blood, and the removal of 
the morbid materials, partly in this way. 
Yeratrum viride, although a catalytic, is unlike mercury or 
arsenic, for they counteract inflammatory, or poisonous processes, 
by slow catalytic action on the blood, whereas veratrum has a 
more rapid action, and produces other changes in the character of 
the blood, by its immediate action on the kidneys, skin, and mucous 
membrane, in fact a quick eliminative action produced by agency 
of the excito-sensory nerves. That the relief from inflammatory 
diseases by veratrum is alone owing to a mere dilatation of the 
vessels is not to be supposed, but it is owing also to a change 
in the character of the blood, and an action on the excito-secretory 
nerves, by which assimilation, elimination, and depuration are 
effected, and we thus have in this dilatation of the bloodvessels, 
and contraction of the blood disks, an explanation for the change 
in the character of the pulse. 
Weber proved by many experiments that electro-galvanization 
of the vagus nerve lessened the number of the heart’s pulsations, 
and prolonged the diastolic period ; this, as we have seen, is the 
special action of veratrum viride, and by this almost uniform cer- 
tainty of its action we have attested its very great utility as a PROPERTIES OF VERATRUM VIRIDE. 
83 
means of diagnosis in diseases of the heart and lungs. Weber 
also demonstrated that division of the par vagum caused great 
acceleration of the heart’s pulsations, and from these experiments 
asserts that the par vagum controls the action of the heart. 
The investigations of Marshall Hall, Bernard, and Brown-Sdquard 
show that the pneumogastric nerve does not alone control the heart’s 
contractions, but that other nerves have an equivalent power. Be- 
yond the action of these we find many causes for preternatural 
cardiac pulsations, and we should frequently be deceived if we 
attributed irregularity of the heart solely to any one cause. We 
see by reference to Case 12, that the presence of lumbricbides in- 
terfered with the heart’s action, and prevented the operation of 
the medicine; by reference to Case 11 we find the presence of 
lamellated patches in the veins, frequently produced hurried respi- 
rations, and pulsations, and eventually in a period of excitement 
caused death; in Case 7 we find that mental disturbance increased 
persistently and violently the action of the heart; in Case 8, pain 
alone increased the heart’s rhythm ; in Case 9, miasmatic poisoning 
produced the same result; in anaemia and chlorosis we find the 
same disturbance; and in fatty degeneration of the heart we have 
a lessened action from impaired contractile power; and yet in all 
these cases veratrum has been used, and while its influence con- 
tinued the heart’s pulsations were brought to a more normal 
standard, complete and steady contraction of its chambers taking 
place, and thus stability and volume given to the pulse. In almost 
all disease the heart’s pulsations are disturbed, yet we could not 
suppose that by merely bringing the heart to a normal beat, we 
could cure, or even relieve all diseases; but there are periods 
during many diseases when there is a great functional disturbance 
of the heart, which may be temporarily relieved, while catalytic 
or other proper and necessary medicines may effect a change in the 
system and cure the disease. We thus afford present relief while 
we are working permanent cure. 
We have in the few cases here narrated plainly seen the opera- 
tion of this medicine and the effects produced. Its is first absorbed 
into the blood and there manifests its power, proved to us by the 
imanfest ‘phenomena we witness. As the medicine is conveyed with 
the blood to the heart, and every minute ramification of the venous 
system, it is thus universally distributed to every excito-motor, 
excito-sensory, and excito-secretory nerve, producing relaxation, 
alleviation, elimination, and depuration. 84 
PRIZE ESSAY: 
However slow the pulse, and we have seen in some instances 
with animals that it has been reduced to 16 pulsations in the minute, 
with but few respirations in the same time, there have been no 
symptoms of suffocation ; and in those instances where veratrum 
has been administered to individuals to control diseased action, 
and the pulse has thereby been reduced to 30 beats in the minute,; 
there has been no feeling of suffocation. This is because the blood 
conveys sufficient oxygen, and thus to the last sustains the vital 
wants of the system. When administering veratrum in disease 
we have frequently found the pulsations reduced to 30 beats in the 
minute (the patient expressing a sense of comfort and quietude), 
with a normal respiration of about 18, thus allowing the blood to 
circulate slowly through the lungs, and receive, if anything, rather 
more than its usual amount of oxygen; at any rate we find no im- 
pediment to free oxidation. The blood circulating thus slowly 
through the lungs, and being fully supplied with oxygen, conveys 
it in proper quantities to all the tissues, so that there is no sense of 
suffocation, no demand throughout the system for more oxygen, 
more arterialization. That this full supply of oxygen to all the tis- 
sues is one of the causes of the great relief afforded by veratrum 
viride, is demonstrable in almost every inflammatory case we treat 
with it, for where, before its administration, there was rapid circu- 
lation and respiration, and a sense of suffocation (or which is the 
same thing, the necessity for more air), as soon as its sedative 
effects are felt the circulation and respiration become normal in 
character, because, as a part of its effects, more oxygen was con- 
veyed to the tissues, and, therefore, there was less demand for res- 
piratory action. Eapidity of the circulation and respiration is 
oftentimes nothing more than a demand of the tissues of the body 
for more oxygen. A peculiar state of the blood or nervous system 
prevents the circulating fluid from becoming duly arterialized, the 
tissues of the body suffer in consequence, and make a demand 
upon both heart and lungs to compensate this loss by rapidity of 
both these functions. There are many exciting causes of disease 
which do not alter the appearance of the blood globules, but render 
them incapable of absorbing oxygen in sufficient quantity, and of 
thus carrying on what we may call the respiration of the tissues. 
That the change spoken of,1 produced in the calibre of the ves- 
sels by veratrum viride, and the alteration in the form and appear- 
1 See Section 3, Division 4th. PROPERTIES OF VERATRUM VIRIDE. 
85 
ance of the blood disks, has much to do in the arterialization of the 
tissues, we have abundant proof, so far as we learn by symptoms 
in almost every case of disease treated. We have seen by the 
post-mortem examinations that have been made, that the blood in 
the heart was nearly always fluid, and of a light color, that both 
sides of the heart were filled with blood, and clots were only found 
when death had been induced very slowly, or after the post-mortem 
examinations had been delayed for some time; that the large ves- 
sels of the lungs were filled with florid blood; and that the liver 
was almost always gorged with blood of a light color. 
In death from hemorrhage, convulsions invariably occur, because 
the heart is unable to supply the brain with blood; but we have 
seen that with veratrum viride no convulsions occur before death, 
as in hemorrhage, and not even in the most powerful medicinal 
doses does it produce convulsions. That death from the action of 
veratrum viride is caused by its sedative effects upon the heart is 
proved by the absence of suffocation, convulsions, and convulsive 
efforts at respiration, and by the fact that the oxidation of the 
blood takes place till the last moment. It does not destroy life by 
apnoea, that is, by stopping the respiration, but by syncope, which 
is suspension of the heart’s action. It would seem in this respect, 
as well as in the antidotal action we have before spoken of, to be 
directly contrary to strychnia in its action, for it has been demon- 
strated by Harley that strychnia in poisonous quantities prevents 
the blood from absorbing oxygen and exhaling carbonic acid. 
There is one peculiarity in the action of this medicine that I 
have been unable to account for. When the tincture, the resinoid, 
or the alkaloid of veratrum viride has been given by the mouth 
in medical doses it has produced no purgative action on the bowels, 
but when either of these preparations has been injected into the 
subcutaneous cellular tissue, or into the muscles, it almost always 
induces an action on the bowels. If the rectum is filled with feces, 
they are first discharged, and afterwards small amounts of dark 
mucoid feces, frequently not over a drachm in weight, are dis- 
charged with some tenesmus, and upon post-mortem examinations 
the mucous membrane of the rectum is found reddened and con- 
gested. Why it should act in this way when injected subcuta- 
neously, and not when taken by the mouth, I must leave for 
physiologists to decide. 
Is veratrum viride narcotic? Tully and Osgood state that it 
is. But we see by the experiments and cases already narrated, 86 
prize essay: 
that it is not narcotic in its action, that it does not in any instance 
primarily exalt nervous force, but uniformly depresses it through- 
out the whole period of its operation. 
It differs markedly from narcotics in producing no special 
action on the intellectual function of the brain, but it merely 
renders the patient languid, quiet, unwilling to be disturbed, and 
disposed to sleep. Under poisonous doses the functions of volition 
and sensation are impaired; but this is an effect produced by seda- 
tives, and is due to derangement not of the cerebral, but of the 
excito-motor and excito-sensory nerves through the vascular sys- 
tem on which the veratrum seems to exercise special control. 
Consequently, unlike narcotics, it produces no deliriant action, and 
does not act so markedly on respiration as on the circulation, 
because the respiration is more under the control of the cranial 
nerves. 
Patients under the influence of this remedy exhibit an inten- 
sification of the ordinary physiological law, in virtue of which the 
pulse falls during sleep; the veratrum frequently causing a dimi- 
nution of 30 beats in a minute in a short time, merely by the 
patient falling asleep. I have carefully watched the pulse of 
patients during sleep who were taking this medicine, and have 
never known the pulse to increase suddenly, as is often the case 
with patients on the eve of delirium, under the influence of nar- 
cotics. Indeed veratrum simulates the remedial action of sleep 
by moderating the flow of blood, and thus neutralizes the effect of 
a diminished supply of oxygen incident to inflammation. 
Paramount to all its other actions we see by the many experi- 
ments before us that veratrum viride is a special arterial sedative. 
We see that it regulates the number and character of the heart’s 
pulsations, that it tones and controls the contractions, and thus 
makes more slow the rapid and irritable pulsations of a weak 
heart; and that it lessens the force and violence, and gives modera- 
tion to a heart rendered too vigorous by functional disturbance or 
exciting causes. 
Veratrum viride is antiphlogistic because of its depurative action 
on the blood by means of the tenuous extremities of the nervous 
system—Marshall Hall’s “ methmmatous nerves.” We have seen 
that it does not deteriorate or impoverish the blood like antimony 
and mercury; and it is more than probable that every portion of 
the medicine is soon carried out of the system by means of its 
potent eliminative action. PROPERTIES OF VERATRUM VIRIDE. 
87 
In nearly every instance of its administration it greatly augments 
the secretion from the skin, promotes increased expectoration, causes 
a rapid and increased flow of saliva; and although it cannot be 
said to increase the quantity of urine passed, it certainly largely 
augments its specific gravity, and thus is probably a more potent 
diuretic than though it merely increased the quantity of water ; it 
exerts an eliminative action on the lymphatic and mammary 
glands, and indurations and enlargements disappear under its use. 
These various eliminative actions prove its high value as an anti- 
phlogistic. 
In the relation of experiments upon animals we have given 
many instances where the pulse was reduced below 80 beats in the 
minute, and where nervous force seemed almost exhausted and 
life apparently seriously threatened; and yet in these seeming 
desperate conditions, strength is quickly regained and circulation 
brought to its normal condition by the administration of the pro- 
per antidotes—stimulants. I do not doubt that a fatal result may 
be produced, but such results must be very rare, since the effects 
are mainly instances of depression not of exhaustion. 
Of its modus operandi when used as a means of diagnosis, I have 
spoken fully in the cases related.