Unicorn Root, Starwort, Chamaelirium luteum, also called Helonias dioica. Often confused with aletris, q. v. In some parts of the country is called Blazing Star.

Pilcher's experiments on the action of plant drugs on the uterus gave negative results with helonias. The root contains a bitter principle; and, indeed, two of the bitters, aletris and helonias, are called Starwort. Then, too, there is another plant, Helenium autumnale, commonly called Sneeze-weed and containing helenin.

This latter agent was given elaborate consideration by Lamson, in a paper in The Jour, of Phar. and Ex. Ther., July, 1913. It caused lethal gastroenteritis and failure of the heart and is poisonous to cattle eating it. He suggests its use as a stomachic (the whole plant being used) in small doses. To my personal knowledge, cattle die from the same symptoms after eating either helonias or helenium. It is probable the two drugs would act similarly in man.

These agents - aletris, helenium, and helonias - contain, at least when fresh, acrid substances. In large doses they may all act as emmenagogues and abortifacients; but, when they do so act, it is not because they possess any specific influence upon the womb or ovaries, but from the general constitutional poisoning and gastro-intestinal irritation they induce.

Attention should here be directed to the work of Macht, of Johns Hopkins University, upon the so-called emmenagogue oils - apiol, oil of pennyroyal, oil of savine, oil of tansy, oil of rue, oil of thyme, and oil of turpentine. None of these exhibited the least stimulating action on the uterus. On the contrary, they caused it to relax, and even paralyzed it, pennyroyal, tansy, and apiol being the most toxic, and turpentine the least toxic. These paralyzant actions were shown upon both the normal and the abnormal uterus. These contraction-inhibitory and paralyzant-actions were findings from direct strip tests with weak solutions or emulsions.

Indeed, all pharmacologists are in agreement that very few drugs have an ergot action, and that the so-called "female remedies," with the exception of caulophyllum, q. v., depress the activity of strips of uterine muscle. Macht might just as well have included in his report Pulsatilla, aletris, scrofularia, Scutellaria, dioscorea, viburnum, valerian, senecio, passiflora, mitchella, and helonias as having no stimulating action on the uterus. Indeed, some of them, as is shown under their separate sections in this book, have no direct action of any kind on the uterus.

Now to return to helonias: what do we find with reference to it?

Helonias, helenium, aletris, and some other agents, as well as certain of the so-called emmenagogue oils, cause uterine relaxation and even paralysis, never stimulation, except by general systemic poisoning and gastroenteric irritation. I believe the acrid principles to be largely responsible for the stomachic and uterine sedative action in small doses.

Therapeutics

The acrid principles largely escaping during the process of drying, tinctures and fluidextracts made from recent material should be employed when a sedative action upon the uterus is desired. When a mere stomachic action is desired, this is not so important, since the bitter principles are not volatile.

Helonias is a good bitter tonic and stomachic, but possesses little carminative influence. See "Gentian" for a discussion of the bitters.

Uterine irritation, with a tendency to bearing-down pains and habitual miscarriage, is amenable to carefully regulated doses of this drug. Painful menstruation, uterine reflexes, and uterine colic may rationally be treated with helonias, as well as with other drugs of the same class. Use small doses, beginning with 1 minim fl. and running up. The maximum dose fl. is 15 minims, and it is rarely needed.

These drugs are symptomatic remedies, worth while in various functional disorders; but he is foolish indeed who depends upon them to "cure" serious gynecologic cases. Modern gynecology exacts careful examination, discriminating diagnosis, and then case-management, not mere symptomatic medication. The latter has a place, so do these drugs, as part - only a part - of the whole.