Cimicifuga

Black Snake-root

Black snake-root. The rhizoma and rootlets of Cimi-cifuga racemosa Elliott (Nat. Ord. Ranunculaceae).

Extractum Cimicifugae Fluidum

Fluid extract of cimicifuga. Dose, 3 ss— 3 ij.

Tinctura Cimicifugae

Tincture of cimicifuga. Dose, 3 ss — 3 ij.

Composition

When fresh, the root contains a volatile oil, which possesses in a high degree the characteristic odor of the drug. A true active principle has not yet been isolated, yet Conard has obtained a neutral substance, crystallizable, and having a very acrid taste. The so-called cimicifugin is nothing more than an impure resin, obtained by precipitation from the tincture by the addition of water. The root contains resin, coloring matters, tannic and gallic acids.

Antagonists and Incompatibles

As the preparations of cimicifuga contain tannic and gallic acids, they are incompatible with the salts of iron. Stimulants, as alcohol, ammonia, antagonize cimicifuga therapeutically.

Synergists

In its action, although feeble, cimicifuga lies between digitalis and ergot. Its physiological effects are increased by cold, digitalis, ergot, belladonna, etc.

Physiological Actions

The taste of cimicifuga is bitter and astringent, with an after acrid feeling. In small doses, without producing any sensible physiological effect, it promotes the appetite and digestion. In full doses it increases the gastro-intestinal secretions. On the heart and circulatory system, cimicifuga has an action not unlike digitalis, but less powerful: it slows the heart-beats but increases their force, and elevates the tension of the arterial system. Its effects on the nervous system, when administered in large doses, are very decided. It causes vertigo, dilated pupils, and in many subjects considerable soporific and anodyne effects. There is little doubt that it increases the contractility of unstriped muscular fiber in a manner that resembles ergot, but much less energetically. It stimulates the venereal appetite in man, and promotes the menstrual flow in women. Diaphoresis and increased bronchial secretion are produced by it, and the urine possesses a distinct odor of the drug.

In order to procure physiological effects from cimicifuga, it is essential that preparations made from the fresh root be employed.

Therapy

Cimicifuga is an excellent stomachic tonic, and is especially adapted to the treatment of the irritative dyspepsia of drunkards. In fevers and inflammatory disorders, when the action of the heart is quick and the tension of the vessels low, cimicifuga may take the place of digitalis, but it is much less efficient than the latter. It is an excellent expectorant, useful in bronchitis and in neuropathic pulmonary disorders. Rx Ext. cimicifugae, fl. oz ss; tinct. opii deod., 3 j; syrup, tolu., 3 xj. M. Sig.: A tea spoonful every four hours. This combination is efficacious in acute catarrh (common cold), and in acute bronchitis after the more active symptoms have subsided. Good results have been obtained from cimicifuga in phthisis. It would be idle to claim that it is curative; but, to moderate hectic, to improve the appetite, and to facilitate expectoration, it is undeniably of service. It is in that form of phthisis now called caseous pneumonia that cimicifuga can be expected to relieve symptoms, and not in tuberculosis

Dilated heart, fatty heart, languid circulation, oppressed breathing, general dropsy, are conditions in which cimicifuga takes the role of digitalis, and although less efficient, is safer, especially in the case of fatty heart.

Most favorable reports have been made of cimicifuga in acute rheumatism. Chronic rheumatism, with tumefaction of the joints, lumbago, intercostal pain, and myalgia, are disorders affecting the muscular system, in which this drug sometimes succeeds in a wonderful manner; yet it very often fails, and we are, unfortunately, unable to indicate beforehand the particular kind of cases in which it is most beneficial.

The power of cimicifuga to relieve certain kinds of pain is well established. Neuralgia of the fifth, arising from cold, rheumatic headache, ovarian neuralgia, succeeding to suppressed or arrested menstruation, etc., are forms of pain in which this remedy is frequently very effective.

Puerperal mania, hypochondriasis, and convulsions, due to menstrual irregularities, have been cured by cimicifuga. The greatest successes of this drug have been achieved in chorea. It is useful in those cases which arise about the period of puberty, and are connected with disorders or perversions of the menstrual flow.

Cimicifuga relieves the pains of dysmenorrhoea when of the congestive variety. Heat of head, flushings of the face, pain in the head, back, and limbs, quick pulse, and nervousness, when due to arrest of the monthly flow, are often remarkably benefited by this agent. It has been used to promote parturient pains, to induce uterine contractions after delivery, and to relieve after-pains, but it is inferior to ergot for most of these purposes. It is serviceable in subinvolution of the uterus, and may be given in combination with ergot.

The aphrodisiac effects of cimicifuga render it useful in spermatorrhoea. It is not adapted to physiological spermatorrhoea, which is really a condition of normal plethora, but to those cases in which the organs are relaxed, the erections weak, and the seminal discharges feeble and occur on slight excitement.

To obtain curative effects from cimicifuga, it must be administered in sufficiently large doses to produce some of its cerebral or other physiological actions.

Authorities referred to:

Davis, Dr. N. S. Transactions of the American Medical Association, i. 352. Hildreth, Dr. American Journal of Medical Sciences, October, 1842. Phillips, Dr. Charles D. F. Materia Medica and Therapeutics, London, 1874 p. 39.

Porcher, Dr. Francis P. Resources of the Southern Fields and Forests, p. 18. Ringer, Dr. Sydney. Handbook of Therapeutics, article Actaea. StillÉ, Dr. Alfred. Therapeutics and Materia Medica, vol. ii, p. 662.