This section is from the book "Materia Medica Pharmacy, Pharmacology And Therapeutics", by W. Hale White. Also available from Amazon: Materia Medica Pharmacy, Pharmacology And Therapeutics..
Veratrum Viride. - Synonyms. - American Hellebore. Green Hellebore. The rhizome and roots of Veratrum viride Solander (nat. ord. Liliaceae).
North America, in rich woods.
Rhizome upright, obconical, simple or divided, from 3 to 8 cm. long, and 2 to 4 or 5 cm. thick, externally blackish-gray, internally grayish-white, showing numerous short, irregular wood-bundles. Roots emanating from all sides of the rhizome, numerous, shrivelled, light yellowish-brown, about 10 to 20 cm. long, and 2 mm. thick. Inodorous, but strongly sternutatory when powdered; taste bitterish and very acrid. Resembling Veratrum. - Valerian, Serpentaria, and Arnica, but Veratrum has thicker rootlets, and no odor.
The chief constituents are - (1) Jervine C26H37No3, an alkaloid, non-sternutatory. (2) Pseudojervine, an alkaloid, resembling Jervine. (3) Veratroidine, sometimes called Cevadine, uncrystallizable, and sternutatory, is probably mostly Rubijervine. (4) Resin.
Dose, 1 to 5 gr.; .06 to .30 gm.
Dose, 1 to 5 m.; .06 to .30 c.c.
a. Tinctura Veratri Viridis. - Tincture of Veratrum Viride. Veratrum Viride, 400. By maceration and percolation, with Alcohol to 1000.
Dose, 2 to 10 m.; .12 to .60 c.c.
It should be remembered that Norwood's Tincture of Veratrum Viride, which is found in the shops, is one-tenth stronger than the official.
The action of veratrum viride is very complex, as it contains so many alkaloids, but experiments have only been made on two active principles. These are jervine, and a substance, veratroidine, which further analysis shows to consist chiefly of rubijervine, resin, and, perhaps, some other bodies. Jervine, veratroidine, and veratrum viride will be considered separately.
Jervine. - Gastro-intestinal tract. - When administered internally this substance produces profuse salivation, but neither vomiting nor purging.
Circulation. - The pulse is markedly lessened in frequency if the animal is quiet, but often the convulsions produced by the jervine cause a rapid pulse. The force of the cardiac beat is not at first altered. The blood-pressure falls at once, and continues to fall till death. Experiments made by excluding different parts show that these effects are produced by a powerful direct depressant effect on the cardiac muscle itself, and that the vaso-motor nerve-centres are powerfully paralyzed.
Respiration. - This is profoundly depressed, and death takes place from asphyxia.
Nervous system. - Early in the case there is muscular weakness, and this becomes more and more marked, so that the animal cannot stand, and reflex action is abolished. Yet, weak as these muscles are, they are soon violently convulsed, and it is found that jervine produces these apparently contrary effects by energetically stimulating the cerebral motor centres, but at the same time paralyzing the anterior cornual cells of the spinal cord, although not sufficiently to prevent the very strong impulses from the cerebral centres reaching the muscles and causing convulsions. The muscles themselves and the motor and sensory nerves are not affected; or, if they are, they are depressed a little, just before death. Consciousness and the pupils are uninfluenced.
Veratroidine. - Gastro-intestinal tract. - This substance always produces vomiting and sometimes purging.
Circulation. - At first it lessens the pulse-rate because it stimulates the pneumogastric, consequently the blood-pressure falls, and if artificial respiration is kept up these effects continue till, if very large doses have been given, the stimulation of the vagi passes into paralysis, and then the pulse rises in frequency. Veratroidine probably has no action on the vaso-motor centres. Its influence on the respiratory centres is so intense that if artificial respiration is not maintained, the effects of the asphyxia so mask those of the drug on the vagi that the blood-pressure rises, and the pulse becomes rapid.
Respiration. - The function of respiratory centres is powerfully depressed, the animal soon becomes asphyxiated and dies.
Nervous system. - The action is the same as that of jervine.
Veratrum Viride. - The symptoms produced by this drug in man are as follows. They are easily explained by the combined action of jervine and veratroidine: - The frequency and force of the pulse are profoundly depressed. There may be severe nausea and vomiting. After large doses the pulse becomes very feeble and uneasy, there is difficulty of respiration and intense muscular weakness. Convulsions are not common in man. The temperature may fall several degrees.
It is the opinion of most authorities that veratrum viride should be prescribed with great caution, as it is such a powerful poison. Veratrum viride has been successfully employed for many years in the treatment of puerperal eclampsia, and of the drugs generally employed for this purpose it is the most reliable. It has been given as a cardiac depressant, but antimony and aconite are much safer. Some have, however, claimed that it is a better cardiac depressant than aconite, because the vomiting it induces quickly indicates that too large a dose has been administered; but if the pulse is carefully watched, too much aconite need not be given, and the vomiting itself is objectionable.