ANGUST. SPUR. False Angustura Bark, erroneously called Brucea antidysenterica. (See “New Materia Medica”).
GENERAL REMARKS.
At the time when this drug was proved in this country, under the direction of Dr. Hering, it was supposed to be derived form the Brucea-antidysenterica, and thence received its name. According to more modern investigations, however, it has been decided to arise from a variety of the Strychnos species, similar to, if not identical with Nux-vomica. Pereira unequivocally pronounces it the Nux-vomica, and gives numerous cases of poisoning, which certainly would appear to substantiate his views the symptoms observed being identical with those produced in acute poisoning with the Nux-vomica; but the matter appears to be involved in some doubt. Dunglison, however, looks upon the Nux-vomica as a different plant and recommends the preparation of Brucin from the Brucea-antidysenterica in preference to the Strychnos Nux- vom., in consequence of the Brucin from the latter being always combined with a small amount of Strychnia. It is distinguished from the Angustura-vera by its greater thickness, hardness, weight, and compactness; by its resinous fracture; by the appearance of its epidermis, which is sometimes covered with a ferruginous efflorescence, sometimes is yellowish-grey and marked with prominent white spots; by the brownish color and smoothness of its internal surface, which is not, like that of a genuine bark, separable into laminae; by the white, slightly yellow powder which it yields; by its total want of odor, and by its intense tenacious bitterness. Analysed by Pelletier and Caventou, it was found to contain a peculiar alkaline principles, which they called Brucin, and upon which its poisonous operation partly depends. In consequence of its presence, a drop of Nitric acid upon the internal surface of the bark, produced a deep red spot. The same acid, applied to its external surface, renders it emerald green. IN the true Angustura-Bark, a dull red color is reduced by the acid on both surfaces. At present it is generally believed to be derived from the Strychnos Nux-vomica, the bark of which, according to Dr. O’Shaughnessy, exactly corresponds with the description given by authors of the False Angustura, and like it contains Brucin.
RATIONALE OF ITS ACTION.
It is classed among the simple tonics or bitters, and is very similar to them in its action, through perhaps rather more energetic in larger doses. In small doses its effects resemble those of Gentian, Columbo, Quassia,. Emmert, from thirty experiments on animals, concludes that the following are the principal effects of Angustura-spuria: Difficult, and at first quickened respiration; frequent, and afterwards spasmodic pulse; an anxious, timid state of mind; diminished control of the muscles, especially of the inferior extremities; spasmodic rigidity of the limbs, and frequently of the muscles of the chest; trembling as if from electric shocks; jerkings and startings, especially along the spine, excited by great, slight, or even scarcely perceptible impressions; attacks of tetanus, especially in the form of opisthotonos, excited by the slightest causes; in these attacks the head and spinal column are bent back in the extremest manner, and the limbs are stretched out; the chest and limbs fixed and rigid; the eye-lids and pupils are extended to the greatest degree, and the eyes are projected rigidly and immovably far out of their sockets; the lower jaw is pressed firmly against the upper, and the face is distorted; the pulse becomes slow, small, and spasmodic; respiration ceases almost entirely, and red parts become blue.
17 In from one and a quarter to one and a half or two minutes the tetanic paroxysms relax, the pupils and eye-lids contract, the eyes sink back into their sockets, and the body becomes soft and flabby, respiration returns with difficulty and great exertion, but gradually becomes freer, and still remains obstructed, and the arterial blood continues darker than natural; the pulse becomes more frequent, larger, and freer, but still remains somewhat tense and hard. The irritable and excitable state of the muscles still continues, and the nervous attacks return at loner or shorter intervals. Consciousness and sensation are not at all lessened, but are rather heightened, and a certain timidity and fearfulness is developed which may be compared to the pantophobia of hydrophobia. No perceptible evacuations are caused by Angustura spuria; vomiting does not occur, nor diarrhoea. After death the irritability of the muscles and nerves is not diminished; the involuntary muscles retain their irritability longer than the voluntary, and the heart is not paralyzed. The rigor-mortis sets in more decidedly and quicker than common. Putrefaction is not hastened, and no organic post- mortem appearances are found, except a great accumulation of venus blood in the large veins, and even in the arteries. Still this venous blood does not exhibit any other alteration, but coagulates in time like other venous blood, and undergoes the same changes from exposure to the air. The general effects of the remedy are experienced in about seven mines, and occur suddenly; it proves rapidly fatal, often in the first attack of tetanus. Convalescence is slow, and the lower limbs recover more slowly than the upper. Death takes place from a general nervous affection, attended with spasmodic rigidity of the chest and consequent obstruction of the circulation. On account of the large quantity of Brucea which the False Angustura contains, it will be proper to make a few remarks on this substance.
BRUCEA
The alkaloid Brucea or Brucin was discovered by Pelletier and Caventou in 1819, in the bark of False Angustura. Pure Brucin, obtained by a process of precipitation, is of a white color, and in regular crystals of the form of oblique prisms, having a base representing a parallelogram; it has a pearly lustre, and very bitter taste. With acids, Brucea forms neutral salts, which differ from the salts of Strychnia.
EFFECTS ON THE SYSTEM.
It acts energetically on the animal economy in the same manner as False Angustura, but much more strongly. It is similar in its operation to Strychnia, but is considered to be weaker. It requires four grains to kill a rabbit, whilst half a grain of Strychnia is sufficient. A tolerably strong dog, to which three grains of Brucea had been given, was affected with symptoms resembling tetanus, but did not die. Pelletier is of opinion that Brucin, or rather the alcoholic extracts of False Angustura, might be substituted in practice for the extract of Nux-vomica; its action is nearly the same, while there is no danger of its acting too violently. Andral has frequently prescribed it, and his deductions are that it is far more under control than Strychnia. Like Strychnia it has been given in cases of paralysis with varying success. It would appear to have acted most beneficially in that resulting from lead poisoning. M. Bricheteau, from his observations on man, and M. Bouchardat, from his on animals, infer that Brucin is more active than is usually admitted. In paralysis succeeding apoplexy, the former employs it with much advantage, and degree with M. Andral in its being more manageable than STrychnia. He is of opinion that no benefit is to be expected from it in paralysis until six months have elapsed from the attack of apoplexy. Earlier than this it may induce serious effects, owing to its toxical effects on the cerebro-spinal system. Magendie administered it with success in one case of atrophy of the leg, and another of the arm; and Lepelletier suggests its use in impotence.
EFFECTS ON THE NERVOUS SYSTEM.
Nerves of Motion. Some interesting experiments have been made to show that it acts on the spine directly, and not on that organ through the medium of the brain. If an animal be poisoned by inserting the extract of False Angustura bark into its hind-legs after the spinal cord had been severed at the loins, the hind- legs as well as the fore-legs are thrown into a state of spasm; or, if the medulla-oblongata be cut across, and respiration maintained artificially, the usual symptoms are produced over the whole body, by the administration of it internally or externally- the only difference being that they commence more slowly, and that a larger dose is required to produce them, than when the medulla is not injured. On the other hand, when the spinal cord is suddenly destroyed after the symptoms have begun, they cease instantaneously although the circulation goes on for some minutes.
Nerves of Sensation.
It does not act specifically upon these parts but has occasionally effected cures of so-called neuralgias.
Ganglionic Nerves.
We have no evidence that it acts specifically upon these nerves, but it may be supposed that it does act upon those portions of the great sympathetic nerve which preside over the involuntary muscles.
ON THE VASCULAR SYSTEM.
Heart and Arteries. It doubtless acts specifically upon the muscular coat of the heart; and also upon that of the arteries.
