Gelsemium is indicated in those maladies in which an exaltation of function has taken place in the motor and sensory spheres of the nervous system. Several cases of tetanus have been reported cured by this remedy; but it is impossible to say whether these were examples of post hoc or propter hoc. A priori it might be expected that gelsemium would prove serviceable in this disease, because its action on the spinal cord is opposed to that which takes place in tetanus. In strychnine-poisoning in animals, however, the tetanic spasms are not prevented by the administration of gelsemium. In mania, with great motor excitement and wakefulness, this remedy is more useful than conium. To bring about the best results from its administration, doses of sufficient strength must be given to produce definite physiological effects, viz., dilated pupil, drooping of the eyelids, and a feeling of languor. In the condition of "horrors" from alcoholic excess, in simpie wakefulness, in the insomnia which results from over-excitement and too great physical activity, cures are not infrequently obtained by the use of gelsemium. In the inflammatory affections of the meninges, and in cerebrospinal meningitis, sporadic or epidemic, with a decided febrile reaction, this agent is extremely useful in small doses (τη v of fluid extract), repeated every two hours so as to maintain a uniform physiological effect.

Gelsemium has been used with success recently in the treatment of neuralgia of the fifth nerve, but the good effects of the remedy in the painful affections of the fifth nerve are not always manifest (Berger). Cases cured by this remedy were, doubtless, not instances of tic-douloureux, but nerve-pain caused by cold, rheumatism, or temporary excentric irritation. Intercostal neuralgia, sciatica, and especially myalgia, are frequently cured by this agent (Jurasz); but considerable doses are necessary—from five to twenty minims of the fluid extract every three hours until the characteristic drooping of the eyelids, dilatation of the pupil, and muscular languor, manifest themselves.

In convulsive or spasmodic cough, gelsemium often affords remarkable relief. It is beneficial in the spasmodic stage of whooping-cough, reflex cough from irritation of the laryngeal nerves, the irritative cough of phthisis with scanty expectoration, and the nervous cough of hysterical subjects. In some cases of spasmodic asthma great relief is afforded by gelsemium, but, as is the case with all other remedies for asthma, it frequently fails and loses its good influence even in those cases in which it was at first successful.

The author has witnessed excellent results from the use of gelsemium in acute inflammations of the lungs and pleura. In pneumonia it affords rest by diminishing the activity of the respiratory function; it allays cough, and, by depressing the cardiac movements, it lessens stasis of the pulmonary capillaries and lowers the temperature. It is better to give medium doses (τη iij—τη v of the fluid extract), every two hours, to maintain a constant effect within the limits of safety. It favors, when exhibited in this way, the occurrence of an early crisis, and assists in the production of one critical evacuation—the sweat. A similar mode of administration should be pursued in pleuritis, in which its use is equally rational and effective.

Very great relief is afforded by the use of gelsemium in certain pelvic disorders in women. There is no more generally-useful medicine in ovarian neuralgia. The pains of dysmenorrhoea are also greatly alleviated by it. The evidence is conclusive that this remedy also suspends after-pains, and it is held by some good observers that it quiets the "nagging" pains of the first stage of labor. In these disorders of the female sexual organs, it is generally necessary to administer a quantity of the remedy sufficient to produce some of its characteristic physiological effects. According to Bulkley, it is an effective remedy for the relief of pruritics, and has given excellent results in the treatment of eczema. He prescribes from three to ten drops of the tincture, giving it every two or three hours until some of its characteristic effects appear.

The first empirical use of gelsemium was in the treatment of the remittent or so-called bilious fevers of the South. A considerable number of facts have been accumulated, which show that this remedy exercises a really beneficial influence in remittent and typo-malarial fevers. It is not an action of specificity—like quinine in intermittent and remittent fevers—and it is doubtful whether this supposed beneficial effect has any proper basis.

Authorities referred to:

Bartholow, Dr. Roberts. Experimental Investigations into the Actions and Uses of Gelsemium Sempervirens. The Practitioner, London, vol. v, p. 200.

Berger, Dr. 0. Berlin, klin. Wochenschrift, Nos. 43 and 44, 1875.

Bulkley, Dr. L. Duncan. New York Medical Journal, May, 1881.

Fredigke, Dr. Annuaire de Thérapeutique. Articles

Acide Gelseminique and Gel. semine.

Holmes, M. Du Gelsemium Sempervirens. Annuaire de Thérapeutique, 1877, p. 41.

Jurasz, Dr. Centralblatt f. d. med. Wissensch., No. 31,1875.

Ott, Dr. Isaac. On Gelsemia, pamphlet, 1865. Also, Philadelphia Medical Times, vol. v.

Porcher, Dr. Francis Peyre. Resources of the Southern Fields and Forests, p. 501.

Wormley, Dr. Theodore. A Contribution to our Knowledge of the. Chemical Composition of Gelsemium Sempervirens. American Journal of Pharmacy, vol. xlii, January, 1870.