NOTE. – Since the above was written, I have had ample opportunity of testing the value of Kola in functional heart disturbances. It acts admirably as a regulator of arythmical action, especially when the cardiac disturbance is due to gastric irritation. In chronic diarrhoea of children and adults, with undigested stools, etc., it has acted admirably.
STIGMATA MAIDIS.
Corn-silk was first introduced and used as a sedative remedy in irritable conditions of the whole urinary tract. It was considered as an analogue of Triticum repens, but was soon found to have a wider sphere of action. Not only is it one of the most potent remedies in irritable conditions of the ureters, bladder and urethra, but it is a powerful diuretic in renal disorders, unconnected with cardiac derangements. Still later, a French investigator, Dr. H. Dupont, has studied its action on the heart, and thus sums up the results:
1. It renders the heart’s action slower and stronger.
2. It regulates the rhythm.
3. The diuretic action is almost always manifested the very first, and goes on increasing up to the thirteenth or fourteenth day.
4. In cardiac affections, with oedema of the lower limbs and general dropsy, this beneficial action is the most prompt and most evident.
5. While the dropsy diminishes, and often disappears, the arterial tension increases the venous tension is reduced concurrently; the general condition becomes decidedly improved, and, in particular, the author mentions a subjective feeling of calmness and bien etre, except that there is pronounced dyspnoea, which it does not remove. (Convallaria has the same effect and also removes the dyspnoea.) In hypertrophy and stenosis Stigmata maidis always produces good results. The author thinks it acts more powerfully than Digitalis and with about the same energy as Convallaria, but that it is to be preferred because it never produces unpleasant effects. When I read Dr. Dupont’s report I could hardly believe that the Corn-silk, so apparently inert, tasteless and simple, could be capable of such profound influence, but I have verified the truth of his assertions in several cases. Dr. H. uses an “extract;” he does not give the formula. I have found the fluid extract, in doses of twenty to forty drops, three or four times a day, to be effectual.
Dr. W.H. Burt reports a cure of symptoms simulating angina pectoris by means of this remedy.
Dr. Crull (Therap. Gazette) writes: “In organic heart disease, when there is deficiency of urine, it will act as a mild but certain diuretic, increasing the flow of urine when stimulating diuretics have failed. The fluid extract of Corn-silk given in drachm doses, alternated with fifteen drop doses of Cereus bonplanti, I consider two most excellent remedies and palliatives in functional and organic diseases of the heart.”
This same writer admits that he has seen considerable irritation of the bladder and kidneys arise from such doses of Corn-silk long continued. It is probable that experiments on the healthy, if carried far enough, would show that it was capable of causing severe and chronic lesions in the kidneys.
STROPHANTHUS AND STROPHANTHIN.
Effects. – The action of these preparations on the heart, as hitherto observed, is said to be an exceedingly beneficial one. A constant and rapid subsidence of an excited pulse is brought about within a few minutes; and neither the digestive troubles nor the cumulative effects so often consequent upon Digitaline medication have been observed, even after several weeks’ use of the Strophanthus preparations.
Discovery. – Medical since is indebted to Professor Fraser for the first accounts, given in the year 1871, of Strophanthus, and of the toxic principle contained in the seeds of this plant.
History. – Two years later, “Just’s Botanic Annual” published a more detailed description of the plant. According to it, Strophanthus is an exogenous creeper, belonging to the Apocyneae, climbing the highest trees, and indigenous to the valley and mountain forests situated above the Victoria Falls of the Zambesi.
Description. – The fruit of the plant ripens in June. It is a pod, growing up to twelve inches in length, composed of a rough external and a somewhat leathery internal shell, containing as many as 200 seeds. The seeds are about fifteen to twenty millimetres long, four millimetres broad, and one millimetre thick. At one end they taper off to a fine point, culminating in a stalk nearly nine centimetres long, of a silky gloss, delicate and brittle, and protrude on all sides in the shape of a sprinkling whisk. At their base the seeds are obtuse, of a yellowish-white color, and covered with a layer of soft, silky and closely adherent hair. At present, there are two kinds of these seeds in the market, a greenish-brown and a white variety. The former, said to be the fruit of Strophanthus hispidus, was defined as Kombe seed (parent plant, Strophanthus Kombe, Oliver) by Professor Oliver, of Kew. The question of the identity of these seeds does not appear, however, to be definitely settled as yet; and the possibility is therefore not excluded that the white variety are the Kombe seeds, from which the natives prepare the Kombe poison.
The seeds contain, besides fixed oils and albumen, that intensive poison which, by the name of Kombe Inee, or Onage, has been used for a long time in West and Central Africa for poisoning arrow-heads.
A green tincture, containing the active principle in solution, may be extracted from the seeds by means of strong alcohol. If, previous to this, the fixed oil of the seeds be extracted by ether, this ethereal solution will likewise contain a certain percentage of Strophanthin; and to this fact, in part, the slight efficacy of the commercial alcoholic tincture of Strophanthus is attributed. The Strophanthin produced by me from Strophanthus seed is a white crystalline powder, melting at about 185 degree C., evaporating without residue, and showing very intensively the reactions of Elborn and Helbing.
Both Strophanthus tincture and Strophanthin are employed in medicine. The tincture is of a pale yellow color, has a peculiar penetrating odor, and a persistent, bitter taste; the dose is of 5, 10, up to 20 drops, twice a day, to be taken either pure or in Aqua Laurocerasi. The single dose of Strophanthin is placed by British physicians at.0003 grammes. In the Vienna Imperial Public Hospital, it is used to the extent of one to two milligrammes per diem, ordinarily dissolved in Aqua Laurocerasi, and given a drop at a time.
A little more than a year ago, Professor Fraser, of Edinburgh, published the result of fifteen years’ experience with a drug till then all but unknown to the medical profession. The feeling of respect due to such an accurate observer and careful experimenter as Fraser, the experience of several of our New York associates, as well as the comparatively recent facts brought to my notice in our own community, are the reason of my calling your attention, this evening, to the use of Strophanthus in diseases of the heart.
In the British Medical Journal of November 14th, 1885, one may find the full account of Fraser’s experiments; and I will, therefore, only call your attention to a few of the most important characteristics of the drug, hoping thus to induce you to give it a careful trial in your own practice, if you have not already done so.
The plant is indigenous to Africa, and is used by the natives as a poison for arrow-heads. It is of the Digitalis group, and has a distinct action upon striped muscular fibre, and also upon the heart, and, in poisonous doses, causes greatly increased and almost continuous cardiac systole, with consequent paralysis of the heart and early cadaveric rigidity. By a series of experiments, patiently carried out over a number of years, both clinically and in the laboratory, Fraser has arrived at the following conclusions:
First. – That Strophanthus has a distinct action, like Digitalis, in increasing the force of systole, at the same time diminishing the rapidity of the heart’s action; whether by stimulation of the organ or direct action upon the heart’s muscle he is not prepared to say.
Second. – That it has little or no effect upon the bloodvessels, and, therefore, causes less blood-tension than Digitalis, which, either by vaso-motor influence or direct action, or both, causes a contraction of the vessels, with a consequent rise of blood- tension.
Third. – That it causes less gastro-intestinal disturbance than Digitalis.
Fourth. – That it possesses, like Digitalis, both antipyretic and diuretic properties.
Fifth – That, unlike Digitalis, it is not cumulative in its effects; and
Sixth. – That it may be used in smaller doses than Digitalis.
If Fraser’s conclusions prove true in practice, we find a decided weight in the balance in favor of Strophanthus; and, although experience teaches us to be cautious in accepting the much vaunted virtues of any new remedy, yet the facts brought to our notice by one of such eminence should make us unhesitatingly experiment for ourselves.
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.