Apocynum cannabinum

Lecture XIV — The Vegetable Kingdom — Apocynaceae: Apocynum cannabinum, Oleander, Vinca minor and Alstonia scholaris

I have now reviewed the majority of the medicines derived from the animal kingdom, and also the most important of the nosodes. We come next to the second grand division in natural history, the vegetable kingdom. The vegetable kingdom offers us many varieties of medicinal substances, some of great practical utility and others having but a limited sphere of usefulness. Drugs obtained from this kingdom owe their medicinal effects to the juices which they contain, or to certain properties which reside in the roots, flowers, or seeds. The medicinal qualities of a plant may be obtained from various parts of it, and these qualities may vary with the part. It is said of Belladonna, for instance, that one part of the plant gives us more of the acrid qualities of the drug, while another gives us more of the narcotic properties. We must be careful then in making a proving of a vegetable drug, that we are certain of the part of the plant we are using; and in publishing our proving, we should state whether the whole plant was used, or only a single part of it. If but a single part was utilized, we should state accurately which part, as the root, the flowers, the seeds, etc.

A study of the vegetable kingdom involves to some extent a study of the mineral kingdom, because many of the medicinal properties of vegetable remedies owe their existence to substances derived from the minerals in the soil in which they grow. The principal effects of some of the grasses are the result of the large quantity of Silica they contain. Xinet3 T-nine one-hundredths of the effects of Lata-ocerasus come from its Hydrocyanic or Prussic acid, which is commonly classed with the inorganic compounds. The same may be said of Amygdala persica. Now these substances derived from the mineral kingdom and contained in the vegetable kingdom, become more active in their new environment; that is to say, a given chemical substance, if made synthetically in the laboratory, would possess less marked medicinal virtues than if it were obtained from a plant. The above remarks also apply to the animal and vegetable kingdoms. Substances existing in the animal kingdom and found also in the vegetable, are far more ii active in the former. Thus the Colorado potato bug, which feeds on potato-plants and derives from thence Solanine, presents more powerfully the symptoms of the latter than does the Solanine itself. We shall study the remedies derived from the vegetable kingdom according to the classification of botanists. There are some incongruities in the botany of to-day; for instance, in the leguminous order of plants from which we get peas and beans, which are very nutritious, is also placed the I^athyrus, which has very poisonous properties. Because there is an outward resemblance between the Lathyrus and sweet-pea, it seems not a little incongruous to put them together, when their effects are so different.

The five relations of drugs, which I have already mentioned, apply here as in the animal kingdom. There is this to be remembered, that substances having the same origin generally do not follow each other well. For example, if you have given Ignatia, it is not well to follow it with Nux vomica, and vice versa, because they both contain Strychnia. Though they have many symptoms in common, they act too much in the same line. Another example may be noted in Glonoin and wine. When Glonoin was proved, it was found to have a decided action on the pulse. All the symptoms w rere aggravated when the provers took wine. Wine produces an excitement very similar to that of Glonoin, but its action seems to be in the same direction, consequently it intensifies the effects of the latter.

But the different orders, sub-orders and classes into which botanists divide plants are so extensive and cover such vague resemblances, that we cannot confine ourselves strictly to the above rule regarding the sequence of drugs. Take for instance the Ranunculaceae, from which we obtain Pulsatilla, Aconite, Helleborus, and Staphisagria .

Now the resemblances between these four drugs are not so close that they cannot follow each other without injury. If we find, then, from our study of symptomatology of the drugs that there are no marked resemblances between them, the rule does not apply. In the Anacardiaceae the rule does not apply with regard to Anacardium and Rhus tox. These drugs bear a family resemblance, but their points of divergence are so great that one drug may act as an antidote to the other. The rule, however, does apply to Ignatia and Nux vomica, and to Pulsatilla Nuttalliana and Pulsatilla pratensis. I will now take up the consideration of the individual drugs derived from the vegetable kingdom. Apocynace^E.

In the order of Apocynaceae there are a number of plants which we use as medicines. Among these may be mentioned Apocynum cannabinum and androscsmifolium, Gelsemium sempervirens , Vinca minor, Olea?ider, Nux vomica, Ignatia. Curare, Alstonia scholaris, and Spigelia. By some authorities Gelsemium, Nux vomica, Ignatia, Curare, and Spigelia have been included in another order, the Loganiace<z. This order of plants is very poisonous; they depress the nervous system, causing prostration, and even narcosis and paralysis; some of them cause death.

Apocynum Cannabinum.

Apocynum cannabinum was said by Pliny to be fatal to dogs, and from this circumstance its name was derived. It has a tough fibre, like hemp, which has been used for cordage.

Apocynum has a marked effect in increasing the flow of urine. It is not sufficient, however, in the present course, to study the drug simply as a diuretic, because it has such a decided action on the vital forces that it demands a more extended notice. It depresses the vital forces greatly, as evidenced in the relaxed sphincters, loss of muscular power, etc. This loss of power is an important general symptom, since it qualifies, as we shall see presently, the cardiac, renal and intestinal symptoms.

In the last few years Apocynum has come into very extensive use in the treatment of many forms of dropsy. When I give you a resume of its symptoms, you will see that its indiscriminate use in dropsical conditions is by no means strictly homoeopathic. When not properly indicated symptomatically, it is necessary to exhibit it in large doses in order to produce any effect. Scoparius (broom-corn) and also the pods of some of the Leguminosae, cause increased functional activity of the kidne}'s and so aid in the elimination of the dropsical effusion. But we have to deal with an art that admits of no such prescribing. It aims at definiteness, not generalization. It teaches the selection of a similimum, not of a temporary palliative.

When indicated Apocynum demands that the following symptoms be present: bewilderment and heaviness of the head; drowsiness and debility or disturbed, restless sleep. The functions are sluggish. The pulse is slow. The bowels are constipated, although the faeces are not hard. The kidneys are torpid, or else the urine is copious and urination is almost involuntary from relaxed sphincters. The nose and throat are filled with thick yellow mucus on awakening. The patient has a sense of oppression at the epigastrium and chest; he can hardly get breath to speak, even after lighter meals than usual; he must take frequent deep inspirations. There are also fluttering of the heart, and dartings and prostrated feeling in the cardiac region. The pulse is irregular, intermittent and at times feeble, then slow. The heart beats regularly, then flutters and becomes feeble, then slow and labored, now and then losing a beat. This is just the group of symptoms characteristic of cardiac dropsy, and it shows what an affinity the drug has for the cardiac region. It will often palliate even in fatty degeneration of the heart, with dropsy, in old people.

Here you may compare several remedies: first, Arsenicum. This remedy has the same thirst and the same sinking at the epigastrium as has Apocynum, but it is indicated in more advanced cases, and the patient always presents more irritability of fibre.

I showed you the distinction between Apis, Acetic acid, and Apocynum when I lectured on Apis.

Helleborus and Digitalis are similar to Apocynum in causing torpidity, slow pulse, etc. But I think that Apocynum, as a rule, is the preferable remedy, unless the symptoms point very strongly to one of the other two.

Apocynum also has some action on the joints, producing a rheumatic condition. The joints feel stiff, especially on moving in the morning.

You may recall that I mentioned Apocynum as a remedy in hydrocephalus. The head is large; there is bulging of the frontal bones; the fontanelles are wide open; there is squinting, and, in extreme cases, the patient is blind; one side is paralyzed. The case closely resembles Apis, but lacks the cephalic cry. It is indicated in more advanced cases than Apis. One or two cases have been cured by the continued use of the remedy.

There is a diarrhoea which may call for Apocynum. The stools are copious, yellow, watery, or brownish, and sometimes contain undigested food. They are discharged with an expulsive force like a cork from a bottle. The sphincter ani is so weak that stools escape unbidden, or while the patient is passing flatus. After stool, he feels weak or has an " all-gone feeling" in the abdomen. The face is pale and covered with a cold sweat.

Aloe has a similar weakening effect on the sphincter ani, and great prostration after stool; but the stools under this remedy contain a jelly-like mucus, are apt to be worse in the morning, and there is a colic which is relieved by bending double.

Gamboge has stool preceded by excessive cutting about the navel. The stool is expelled " all at once" after considerable urging, and is followed by a feeling of great relief.

Apocynum also has haemorrhoids, which are associated with a feeling as if a wedge were being hammered into the anus.

Anaca?-dium is another drug which has a sensation as though a plug were being forced up into the anus.