Colchicum

Meadow Saffron

Meadow saffron. Colchique, Fr.; Zeitlose, Ger.

Colchici Radix

Colchicum-root. The corm of Colchicum au-tumnale Linné (Nat. Ord. Liliaceae).

Colchici Semen

Colchicum-seed. The seed of Colchicum au-tumnale.

Preparations

1. Of the root.

Extractum Colchici Radicis Fluidum

Fluid extract of colchicum-root. Dose, τη ij—v\ v.

Vinum Colchici Radicis

Wine of colchicum-root. (Four hundred grm. of colchicum-root; alcohol, 150 c. c; white wine to make 1,000 c. c. Dose, τη v—v\ xxx.)

Extractum Colchici Radicis

Acetous extract of colchicum-root. Dose, gr. ss—gr. ij.

2. Of the seed.

Extractum Colchici Seminis Fluidum

Fluid extract of colchicum-seed. Dose, τη ij—τη x.

Tinctura Colchici Seminis

Tincture of colchicum-seeds. (Col-chicum-seeds, 150 grm., to 1,000 c. c. of diluted alcohol.) Dose, τη x

— 3j.

Vinum Colchici Seminis

Wine of colchicum-seed. (One hundred and fifty grm. of the seed; alcohol, 150 c. c; a sufficient quantity of white wine to make 1,000 c. c.) Dose, τη x— 3 j.

Composition

Tannic and gallic acids, starch, sugar, gum, a peculiar alkaloid, colchicina or colchicine. Colchicine is easily converted (by acids, in long-kept alcoholic preparations) into an isomeric, cystallizable body, colchicein. The amount of the alkaloid contained in the root and the seed is said to be not greater than the half of one per cent. Colchicine is not crystallizable, but combines with acids to form crystallizable salts. The conversion, in any of the pharmaceutical preparations, of colchicine into colchicein, does not appear to impair the therapeutical activity. That colchicine is the active principle, is proved by the fact that the physiological effects of this alkaloid are the same as those of the crude drug (Husemann)

Antagonists and Incompatibles

Tannic acid, by forming an insoluble tannate with the alkaloid, retards but does not prevent its absorption. When a lethal quantity has been taken, emetics and purgatives are required, and demulcents may be freely administered. Opium and the alcoholic substances antagonize the depression of the heart's action.

Synergists

Such alkaloids as produce gastro-intestinal irritation and depress the action of the heart, e. g., veratrine, aconitine, etc., are synergistic. Therapeutically considered, emetics, purgatives, alkalies, promote the activity of colchicum.

Physiological Actions

Colchicum imparts its virtues to water, alcohol, and ether. It has a bitter taste, and excites the flow of saliva. In small doses it increases the mucous and glandular secretion of the stomach and intestines, and probably also of the liver, kidneys, and skin. If the dose be large but still medicinal, colchicum produces a feeling of epigastric heat, nausea, and vomiting, depression of the circulation, muscular feebleness, headache. It frequently purges, producing copious watery stools, and is generally held to increase the discharge of biliary matters. It increases the flow of urine, of the solid constituents (urea, uric acid, etc.), as well as of the water, and promotes the cutaneous transpiration. In toxic doses colchicum produces all of the local as well as the systemic effects of an irritant poison, viz.: acute abdominal pain, profuse watery and choleriform discharges, suppression of urine, feeble pulse, cold sweat, coldness of the extremities. The intellect remains unaffected until carbonic-acid poisoning supervenes. The muscular cramps which have been occasionally observed are probably due to the great loss of fluid from the system. When colchicine is injected subcutaneously, gastro-intestinal inflammation is produced, showing that it has a selective action on this tissue.

This view of the action of colchicum has been fully confirmed by Dr. Roy. The strongly accentuated impression on the mucosa of the intestine is due, he affirms, to its elimination by this membrane and the profuse watery discharge as a transudation.

Therapy

Colchicum is indicated when rapid wasting of tissue and prompt elimination of the products of waste are required. Its use at the present time is almost entirely restricted to the treatment of gout in its various manifestations. It relieves the pain, diminishes the swelling, and shortens the duration of an attack of acute gout. In order to accomplish these results, it is not necessary that the more harsh and violent physiological effects of the drug be produced. Sufficient quantity of colchicum should be given to increase secretion from the skin, the intestinal mucous membrane, and the kidneys, but nausea and vomiting should be avoided. Combination with an alkali increases the therapeutical effect of colchicum: Rx Spts. ammoniae aromat., 3 xiij; vini seminis colchici, 3 iij. M. Sig.: A teaspoonful every three hours, until some physiological effect is produced. The following is a formula used at the London Hospital for gout: Rx Tinct. colchici seminis,τη xx; potassii bicarbonat., grs. x; aquae pimentae, oz j. M. Sig.: A draught. The following modification of Scudamore's prescription is in use at University College Hospital: Rx Tinct. colchici seminis, τη xv; mag-nesii carb., gr. vj; magnesii sulph., grs. xxx; aquae menth. pip. ad oz j. M. Sig.: A draught. After the more acute symptoms of the gouty attack have subsided, the following was recommended by Sir Henry Halford: Rx Ext. colchici acet., gr. vj; pulv. opii et ipecac, comp., ext. colocynth. comp., āā gr. xij. M. Ft. pil. no. xij. Sig.: One pill night and morning. The efficiency of colchicum is increased by combination with digitalis: Rx Ext. colchici acet., gr. x; pulv. digitalis, ext. colocynth. comp., āā Э j. M. Ft. pil. no. xx. Sig.: One pill twice or thrice a day.

The active principle, colchicine, is, there is reason to believe, more successful in gout than any of the preparations of the crude drug. Rx Colchicinae, gr. j; ext. colocynth. comp., 3 ss; quininae sulph., 3 iij. M. Ft. pil. no. lx. Sig.: One every four hours.

In the so-called rheumatic gout, colchicum with alkalies is extremely serviceable. Attacks, without decided pain and inflammation, of soreness of joints, which have been the seat of gouty attacks, or about which nodosities have been deposited, are relieved by colchicum.

Constipation, hepatic congestion, and headache, due to torpor of the portal circulation, occurring in gouty subjects, are quickly relieved by a combination of colchicum and saline purgatives. The plethoric and overfed without being gouty, suffering from the same group of symptoms, are relieved by the same means. Inflammations of internal organs occurring in gouty subjects, for example, gouty bronchitis and rheumatic pneumonia, are best treated with prescriptions containing a preparation of colchicum. The following prescription is recommended by Greenhow in gouty bronchitis: Rx Potassii iodidi, ammonii carbonat., āā Э j ; vin. colchici seminis, 3 j; tinct. scillae, tinct. hyos-cyami, āā 3 ij; aquae camphorae q. s. ad oz iij. M. Sig.: A table-spoonful three times a day.

Although colchicum is still advocated by some authorities in acute rheumatism, the general professional experience is against its use. In chronic rheumatism, when the joint changes are allied in nature to those which take place in gout, it is unquestionably serviceable. Neuralgia occurring in gouty and rheumatic constitutions is often relieved by colchicum. The indications for its use are plethora, constipation, and deficient excretion of the liver, kidneys, and skin. Colchicum relieves in such cases, by setting up an eliminative process. In hepatic dropsy and cardiac dropsy, when the patient is vigorous, the gastrointestinal tract free from inflammatory mischief, colchicum may be used with advantage as a hydragogue: Rx Elaterii, gr. j; spts. etheris nitrosi, oz ij; tinct. scillae, tinct. colchici, āā oz ss; syrup, simplicis, oz j. M. Sig.: A teaspoonful three or four times a day. The following combination is an excellent diuretic in dropsy: Rx Vini seminis colchici, 3 ss; sol. ammonii acetat., 3 ijss; inf. petroselin, oz v. M. Sig.: A tablespoonful every four hours. This prescription is well adapted to dropsy following scarlatina.

Colchicum is a serviceable remedy in certain cerebral disorders. Thus, it may be used in acute cerebral congestion in plethoric subjects, in uraimic intoxication, in hypochondriasis, especially when due to deficient elimination (uric acid, oxalate of lime, etc.).

The wine of colchicum-seed has frequently succeeded in curing gonorrhoea, and by Brodie a nightly dose of thirty minims was given for the relief of chordee. In the treatment of gonorrhoea, the following may be used: Rx Vini colchici seminis, oz ss; sol. potassii citratis, 2/2 vjss; tinct. opii deod., 3 ij. M. Sig.: A tablespoonful three or four times a day in gonorrhoea.

Authorities referred to:

Brodie, Sir Benjamin. Works by Mr. Hawkins, Diseases of Urinary Organs, vol. ii.

Caspar, Johann Ludwig. Practisches Handbuch der gerichtlichen Medicin. Neu bearbeitet und vermehrt von Dr. Carl Liman, Berlin, 1871, p. 570.

Fuller, Dr. William Henry. On Rheumatism, Rheumatic Gout, etc., 1874.

Greenhow, Dr. E. Headlam. Chronic Bronchitis, etc.

Gcbler, Dr. Adolphe. Commentaires du Codex Medicamentarius, etc., article Colchique.

Hanbury and Fluckiger. Pharmacographia, p. 636.

Hammond, Dr. W. A. The Amerian Journal of the Medical Sciences, January, 1859, p, 278.

Husemann, Drs. Theo. and Aug. Die Pfianzenstoffe, p. 493, article Colchicin.

Roy, Dr. Ch. Archives de Phyriologie, normale et pathologique. New series, vol. v, p. 656.