Veratrum Viride, American Hellebore. Toxic doses depress the circulation and respiration and produce coma and incessant vomiting. While not apt to lead to fatal results, veratrum viride must be used with great care, since it may cause death by asphyxia. Never push beyond slight nausea, and rarely to that point. The action of the drug is prompt, and should be given in doses not over two hours apart, and the patient be rigidly kept in the recumbent position when full doses are administered. It is contraindicated in valvular heart lesions and in asthenic states.

Pharmaceutically, it is hard to work. Green root tinctures are apt to be slimy and weak. The recently dried root is fully effective. The Norwood's tincture is thoroughly reliable. The @ is excellent if sufficiently large doses are given. Squibb's tincture veratrum viride can be depended upon. The ec. tr. is a high-grade fluidextract made of partially dried root, and is probably not so concentrated as to alkaloidal constituents as are fluidextracts from dry but recent root. The numerous alkaloids derived from veratrum viride have no established place in therapeutics.

In large doses it is of decided value only in puerperal convulsions. It is apparently harmless in quite large doses in this condition. Give 10 I. ec. tr., or 8 I. f.e., or, hypodermically, 6 to 8 I. ec. tr. According to conditions, repeat with doses half as large. In one aggravated case I gave 30 I. ec. tr. within two hours, but such heroic doses are rarely safe, although as high as 10 I. hypodermically every fifteen minutes, to effect, have been suggested. The hypo. is really seldom necessary, since veratrum is so prompt in action. Be very cautious with these large doses.

In small doses it is used to slow the pulse when it is full, strong, and large, viz.: in sthenic states. It is indicated in many conditions, such as erysipelas, malignant types of scarlet fever and diphtheria, sciatica, uremic convulsions, exophthalmic goitre, determination of blood to the brain, acute pneumonia, acute tonsilitis, peritonitis, meningitis, some cases of cardiac hypertrophy, acute rheumatism, and sthenic inflammations generally when patient is in bed and stays there. Do not give to persons who are asthenic or to those who are up and about. (F.e. or ec. tr., 1-5 to 2 I.. every half hour to two hours. Tinctures, I to I5 I..) The small dose is safe and effective within its indications, but I I. f.e., or 10 I. tr., is seldom to be exceeded in this connection.