The American (false) White Hellebore. Indian Poke. N.O. Melanthaceae. Tincture of the fresh root gathered in the autumn.
THE principal alkaloid of veratrum viride is veratrine, the physiological action of which has been considered under veratrum album. Veratrine occurs in the plant with other alkaloids, which have unknown, but not poisonous, properties, and with a resin, so that the provings of the tincture made from the plant though presenting a general resemblance to those of veratrum album yet exhibit some differences. For instance, purging is less pronounced than with veratrum album, the nervous system is more markedly affected and its influence on the heart and circulation is greater. Veratrum viride causes marked slowing of the pulse and respiration; in some provers the pulse was brought down to below 40 per minute and the respirations to as few as eight. Thus, though there is great hyperaemia of the brain from veratrum viride, it is a passive hyperaemia or congestion, not an active one like that of belladonna. It causes, however, much irritation of the cerebrum, which may result in convulsion, sometimes opisthotonic choreiform movements, twitchings and jerkings of muscles. The medulla, pons and upper cervical cord are the parts where the congestion is most marked. With this state of congestion of the nervous centres we have a flushed condition of the head and face. Respiration is extremely depressed and becomes very slow. At the same time the vagus centres in the medulla are stimulated, with the result that the pulse is also slowed, while stimulation of the vasomotor centres causes contraction of the blood-vessels. There seems to be a slight stimulation of the cardiac muscle in the early stages of poisoning, later it is weakened. The combination of slow pulse and respiration leads to great congestion of the lungs, even to hepatization, which was induced several experiments on animals. The stomach also is usually congested.
Coming to detailed symptoms we need only take note of those which more or less distinguish veratrum viride from veratrum album. Mental symptoms are similar.
Head.-There is more congestion of the head, which feels full and heavy, especially in the morning; “constant jerking or nodding of the head” is a symptom.
Eyes.-As with veratrum album, the pupils are dilated, and vision becomes dim or vanishes, with partial syncope, on rising or attempting to walk.
Face.-The face, though usually pale, cold and bluish, is more often seen to be flushed, and convulsive stitches in the facial muscles are more frequent than with veratrum album.
Digestion.-The tongue feels as if scalded, and a characteristic appearance is a yellow or white tongue with a red streak down the middle. There is a constant inclination to swallow, and a sensation of a ball rising in the oesophagus, or rumination from reversed peristalsis occurs. Painful vomiting and cold sweat occur; as with veratrum album. With the gastric pain there may be a sensation as if the stomach is drawn back tightly against the spine (plumb.). Pain and soreness across the abdomen just above the pubes distinguish veratrum viride, and purging and choleric stools are less in evidence.
Urine.-The urine is increased and very clear.
Respiration.-Respiration is laboured and very slow, there is much oppression of the chest, it feels constricted, and the lungs rapidly become congested.
Circulation.-The heart’s action is slowed, it is only when large doses have paralysed the vagus centres that the pulse is quickened.
Back and Limbs.-There is aching pain in the neck and between the shoulders, and a tendency to drawing the head back, and to opisthotonos, when convulsions occur. Pains in the limbs are felt, especially about the knees and ankles.
Nerves.-Nervous twitchings and contortions of the body are seen, and a tendency to spasms and convulsions are more pronounced than is the case with veratrum album.
Sleep.-Sleep is restless and dreams are of water.
Skin.-It resembles veratrum album in causing a cold, clammy, bluish, shrivelled condition of the skin, with cold sweats and collapse.
Nerves.-Veratrum has been chiefly used in diseases of the nerves, whether depending on congestion or inflammation, such as intense congestive headaches, cerebral apoplexy, cerebro-spinal meningitis, insanity from cerebral congestion, when there is furious delirium, convulsions in children arising from cerebral irritation, puerperal mania (bell., hyos., plat., stram.), chorea when the jerks occur even during sleep, opium poisoning, and the effects of sunstroke. All these states arise from hyperaemia of the brain or upper portion of the cord, and are amenable to the influence of veratrum viride.
Pneumonia.-It has also gained a considerable reputation in fevers, especially in the eruptive fevers, in inflammations of the heart, and in pneumonia. An indication for its employment given by Hale is, “a full, hard, bounding pulse.” Given on this indication it is not administered homoeopathically, but is used antipathically to control the too vigorous circulation occurring in acute inflammations, in the same way that aconite is sometimes given to depress the pulse and lower the fever. Nash, who at one time adopted veratrum viride as a remedy in pneumonia, discontinued its use as he found it dangerous, patient sometimes dying suddenly when they seemed to be getting. He concluded that it is not desirable to “control” or depress the pulse, regardless of other conditions, and that patients who have not vigorous hearts cannot stand treatment by veratrum viride in pneumonia. The kind of pneumonia to which it is homoeopathic is that in which the pulse and respiration are both slow, a condition not often met with in that disease.
Sexual.-Veratrum viride has been found useful for congestive dysmenorrhoea, pelvic congestions and inflammations and puerperal fever. The provings suggest that it has a local, specific action on the uterus. In those of the above complaints that depend on active hyperaemia, with quickened pulse and high fever, amelioration from veratrum viride must be due to an antipathic action.
Urine.-It has been used successfully in nephritis following scarlet fever; the indications on which it was given were drowsiness with flushed face, restlessness, scanty and albuminous urine, high fever, vomiting and convulsions.
Strong, hot coffee is the best antidote to veratrum viride.
(1) Slow pulse and respiration.
(2) Violent pains attend inflammations.
(3) Suddenness: fainting, prostration, vomiting.
(4) Coldness, blueness, weakness, cold perspiration.
(5) Vertigo on rising, especially in morning.
(6) Coated tongue, with red streak down the middle.
(7) Jerkings, tremblings, choreiform movements.
(8) Congestions : of base of brain, spinal cord, chest, stomach.
(9) Cerebral congestion and irritation; meningitis, convulsions, opisthotonos.
(10) Full-blooded, plethoric persons.
(11) Delirium, mania. Pneumonia.
From motion, rising, walking, lying (headache and breathing), going from warm to cold, after exposure, food (causes vomiting), morning on waking.
From rubbing, pressure (pain in head), lying (faintness and blindness).