The decrease in pulse-force is due to the depressing action of the drug on the heart itself, as is also the arrest in diastole. The increase in pulse-rate is due to inhibitory failure; for in the dog, as well as in the frog, galvanization of the vagi failed to slow the heart. In the next experiment the dose of the drug used was much smaller than before, since it had become evident that the larger doses were absolutely toxic in their character. An eighth of a grain was, therefore, injected into the dog’s jugular vein, curare and artificial respiration being used. As a result, I found that in small doses this glucoside does not cause any primary slowing of the heart, but increases its frequency, its force and the arterial pressure from the first, all three of these features being permanent and constant under the smaller dose. Even with this dose, however, the animal died. A twelfth of a grain given slowly to a large dog did not produce death nor a primary slowing in rate, but seemed to increase the rate, force and pressure. In this last experiment no tracing was taken, the jugular vein only being exposed. I should have stated before that when I poisoned a small dog by a large dose of Adonidin there were symptoms of nausea and intestinal spasm, accompanied by the expulsion of faeces. The animal had no convulsions or spasms, but lay on its side, with pupils widely dilated, and, when death occurred, respiration continued some moments after the heart stopped. The same writer thinks that Convallaria and Caffeine possess higher diuretic powers and less cardiac influence than Adonidin.
Finally, he sums up the results of his observations as follows:
In doses of 1/3 gr. Adonidin –
1. Increases arterial tension.
2. Regulates the heart-beat.
3. Diminishes the frequency of the pulse.
4. Increases the force of the cardiac contractions.
5. Acts with rapidity, its effects being only present during its administration.
6. Increases diuresis.
7. Is well tolerated.
8. That the indications for its use are the same as for Digitalis.
OTHER EXPERIMENTS WITH ADONIDIN.
Huchard presented, in the Societe de Therapeutique, at a meeting held on December 23rd, 1885, a series of cardiographic and sphygmo-graphic tracings taken from patients under treatment with adonidin (vide Gaz. Hebd., January 1st, 1886). Our readers will recall that Adonidin is the glucoside of Adonis vernalis, and was first extracted by Cervello as an amorphous yellowish extract of a bitter taste. The first experiments with the drug were made by Lesage and Montague. The cardiac frequency was found under its influence to be decreased, and at the same time a peculiar state of ventricular rigidity is induced, the ventricle itself becoming pale and anaemic.
Huchard injected 2 to 2 cg. (15/100 to 3/10 gr.) hypodermically into rabbits, and found respiration reduced, the cardiac force raised, disappearance of paralytic symptoms, fall of temperature, and death ensuing after fifteen to twenty hours. In man the infusion of Adonis vernalis may be given in 4 to 8 grammes (1 to 2 dr.) for a dose, four times daily, or, still better in pill form, 4 to 5 daily, 1/10 of a grain each. Huchard reported several cases in which Adonidin had been successful. In one case of interstitial nephritis, with galloping heart-sounds, anasarca and beginning asystole, in which Sparteine had been given in vain, Adonidin induced a profuse diuresis and an unquestionable improvement in the patient’s condition. For some time, however, the drug had to be discontinued, on account of the diarrhoea and vomiting it produced. When the quantity of urine fell off again, the remedy was again exhibited, and again relieved the most urgent symptoms. The diuresis rose two to four quarts daily. At the same time the arterial pressure grew stronger, the pulse more regular and full, and the oedema and cardiac frequency receded. In a woman having a mitral affection, but no heart-murmur, the drug produced a very audible systolic murmur. In typhoid fever, where great reduction of the arterial pressure exists, Huchard thinks the drug might be used advantageously to raise the pressure.
ADONIS AESTIVALIS.
This plant has been examined by Italian doctors as to its therapeutic value, and Albertoni reports in its favor. His experiments were made on animals and sick and healthy people. In cases of insufficiency of heart action, with feeble, irregular, rapid pulse, diminished arterial pressure, dyspnoea and diminished excretion of urine, the administration of the plant in substance produced in a few days the return of normal pulse, increase of the pressure of the blood, and disappearance of the respiratory oppression. The quantity of urine increased from eight hundred to three thousand cubic centimetres in a day.
These good results were not obtained in cases in which the organs susceptible to the influence of Adonis, such as the kidney epithelium, muscular fibre and the nerve apparatus of the heart, had already retrograded to too great an extent.
The dose is 4 to 8 grains a day, given in substance or infusion. The effects manifest themselves about the third day.
Neither of these species of Adonis has been proved in our school. There were some attempts to prove Adonis vernalis, but the results were very meagre. It seems to cause irritation of the bladder, strangury, etc., but all cardiac medicines do that.
BARIUM AND ITS SALTS.
Barium has not yet been used as a remedy in cardiac affections, but it has a decided action on the heart and capillary vessels.
The provings already show this, and also show that, like Digitalis, its primary action is to stimulate the cardiac muscle, and, secondarily, to depress its vitality. The symptoms in a fatal case of poisoning by Baryta acet., reported by Dr. Dartmoor, are: “Pulse 125 to 130, very small and frequent. Pulse 65. Pulse 56, and even as low as 25. Irregular pulse.”
Baryta carb. has : “Violent, long-lasting palpitation. Palpitation when lying on left side. Palpitation renewed when she thinks of it. Pulse full and hard.”
Baryta mur. has : “Beating of the heart very irregular. Pulse scarcely perceptible. Pulse rapid. Pulse soft and irregular.”
Brunton, in his experiments, found Barium to act as energetically as Veratrine. He classes it with Digitalis, Helleborine, Nerein, Scillin, Strophanthus, Caffeine, etc.
Hahnemann says the Baryta salts are useful in the maladies of old age. The condition of the heart and bloodvessels of the old is certainly similar to what we might expect the secondary symptoms of Baryta to be. I shall not be surprised if we find in Baryta the remedy for many cardiac disorders which accompany old age. In senile or fatty degeneration it may rival Digitalis or Strophanthus.
The following statement of its action on the heart and circulation is certainly worthy our study:
SIMILARITY OF BARIUM TO DIGITALIS.
“The salts of Barium, though they have been occasionally employed therapeutically, have never been very generally recognized as really useful therapeutic agents, either in this country or abroad, partly perhaps from a want of knowledge as to their effects both in physiological and pathological conditions. This knowledge Dr. A. Bary, of Dorpat, has recently endeavored to supply, to some extent at least, by making a large number of investigations on the action of the Barium salts on animals, as well as by collecting recorded cases of the therapeutical employment of the drug or its accidental effects as a toxic agent in the human subject. The salt he mainly used was the chloride, a substance with which every one is perfectly familiar in the laboratory, if not in the dispensary. The chief action of Barium appears to be on the heart, showing great similarity to the action of Digitalis, and somewhat less to that of Physostigma. Thus it was found by experiments on frogs that in small doses Barium increased the action of the heart-muscle, and in large doses set up peristaltic movements, arresting the heart finally in systole, this arrest in systole being a tetanic spasm of the heart-muscle, and being capable of being brought to an end by agents which paralyze muscles and by mechanical distension by fluid pressure, but not by the electric current or by Atropin. In very acute poisoning, either by large doses or by the direct application of the Chloride of Barium to the heart, the frog was found, even after the heart was stopped, to be capable of jumping. Again, the isolated apex was caused to beat by Barium, finally being arrested in systole. The arrest caused by Muscarine and Chloral was brought to an end by using this salt. It was found that arrest in diastole could not be produced under its action by stimulation of the vagus or of the sinus venosus. The effects of Barium on the arrest caused by Muscarin, and the want of result from irritating the vagus, were found not to be due to any paralyzing action of the salt on the vagus. The foregoing effects are as nearly as possible identical with those produced by Digitalis, differing also only in a slight degree form those of Physo-stigma. In warm-blooded animals Barium in small doses slows the pulse independently of the inhibitory apparatus. In large doses it first accelerates the pulse, probably by stimulating the accelerating nerve, and finally slows it, in consequence of weakness of the heart. The blood-pressure is greatly increased by Barium. Like Pilocarpin, Barium increases in a marked manner the secretion of saliva, but only when it is injected into the veins, this activity being immediately checked by Atropin, differing in this latter respect from Physostigma. In view of the considerable contraction of the vessels caused by the Chloride of Barium, Professor Kobert has recently made some trials of its use in cases of dilated cutaneous veins, employing it in the form of ointment.
Hale wrote Lectures On Diseases Of The Heart, Materia medica and special therapeutics of the new remedies Volume 1, Materia Medica And Special Therapeutics Of The New Remedies Volume 2, Saw Palmetto: (Sabal Serrulata. Serenoa Serrulata), The Medical, Surgical, and Hygienic Treatment of Diseases of Women, New Remedies: Their Pathogenetic Effects and Therapeutic Application, Ilex Cassine : the aboriginal North American tea, Repertory to the New Remedies with Charles Porter Hart, The Characteristics of the New Remedies, Materia Medica and Special Therapeutics of the New Remedies, The Practice of Medicine, Homoeopathic Materia Medica of the New Remedies: Their Botanical Description etc.