The rhizoma and roots of Hydrastis canadensis Linné (Nat. Ord. Ranunculaceae). Yellow root.

Preparations

Extractum Hydrastis Fluidum. Fluid extract of hydrastis. Dose, τη v— oz ss.

Tinctura Hydrastis

Tincture of hydrastis. Dose, τη x— 3 j.

Glyceritum Hydrastis

Glycerite of hydrastis. Hydrastis, 1,000 grm.; glycerin, alcohol, and water, q. s. to make 1,000 c. c. Dose, τη v—τη xx.

Hydrastininiae Hydrochloras

Hydrastinine hydrochlorate. The hydrochlorate of an artificial alkaloid derived from hydrastine, the alkaloid of hydrastis. It occurs in light-yellow amorphous granules, or a pale-yellow crystalline powder, odorless, and having a bitter saline taste. Soluble at 59° F. in 0·3 part of water. Dose, gr.. -1/40—1/10—1/6..

Composition

Hydrastis contains a peculiar principle, hydrastine or hydrastina, which crystallizes in four-sided prisms, white or colorless when pure, and having but little taste. Hydrastine, the alkaloid, should not be confounded with the eclectic preparation, "hydrastin," which is composed chiefly of berberine.

Antagonists and Incompatibles

The alkalies, tannic and muriatic acids, are chemically incompatible with the preparations of hydrastis. Muriatic acid precipitates berberine, and the so-called hydrastine of the eclectic practitioners is nothing more than berberine muriate. The alkaloid hydrastine is antagonized by chloral, which is, therefore, the appropriate remedy in poisoning by this agent.

Synergists

The vegetable tonics in general are synergistic to hydrastis, especially berberis vulgaris and calumba, both of which contain berberine, and the group of excito-motors favor its action.

Physiological Actions

The preparations of hydrastis have a decidedly bitter taste, and, like other bitters, promote the flow of saliva, and probably, also, of gastric juice. Increased appetite and digestive power result from its administration. It is, therefore, a stomachic tonic. It also increases secretion of the intestinal mucous membrane.

The property of hydrastis as a laxative is due to its effects on the various secretions concerned in the primary assimilation, whence the stools become softer, and to its stimulant action on the muscular fiber of the intestine, whence it increases peristalsis. Until the author's investigations were made in the laboratory of Jefferson Medical College, only vague impressions existed as to the character of its true active principle—hydrastine.

The most conspicuous effect of the alkaloid is the stimulation of the nervous system of animal life, and this power is exerted on cold-and warm-blooded animals, and on man in a uniform manner. Comparative tests demonstrated that the alkaloid and the fluid extracts, colored and colorless, acted in the same way—hence it follows that hydrastine is the true active principle, and that berberine contributes nothing to the impression made on the nervous system, although the stomachic tonic and cholagogue actions must be, in part, certainly referred to this alkaloid.

The most important and characteristic effect of the alkaloid—hydrastine—is that which it exerts on the nervous system of animal life; it is an excito-motor stimulant, and induces such a degree of excitability of the reflexes that the feeblest peripheral irritation causes general tonic muscular spasms, passing from above downward. Presently these tetanic convulsions occur independently, and in the interval between them more or less muscular trembling and paresis occur. This tetanizing action was found to be due to an impression on the spinal cord—is centric and not peripheral in seat. When very large doses are administered, the irritability of the motor nerves is destroyed and the muscular contractility impaired to some extent. Death ensues by tetanic fixation of the respiratory muscles, and hence increasing cyanosis and carbonic-acid narcosis occur.

In medicinal doses (medium) hydrastine stimulates the vagus, but lethal doses destroy its irritability, and the heart's action is arrested in the diastole, the cavities distended. It is then found that the cardiac muscular tissue will no longer contract on electrical stimulation. In ordinary medicinal doses hydrastine stimulates the vaso-motor system causes contraction of the arterioles, and raises the arterial tension accordingly, but in massive or lethal doses the opposite effects obtain.

Comparative experiments have shown that hydrastine not only has many points of correspondence in its physiological actions to strychnine, but its physiological antagonists are the same. The most important of the antagonisms is that between hydrastine and chloral. When the tetanizing action of the former is well advanced, chloral suspends the spasms, and thus prevents the tetanic fixation of the respiratory muscles, which is the mode of dying.

The elimination of hydrastine is effected chiefly by the kidneys, and to some slight extent, probably, by the intestinal glands.

Therapy

Stomatitis, both mercurial and aphthous, is much improved by local application of the fluid extract of hydrastis. When this preparation causes much smarting, it may be diluted with water. Follicular pharyngitis, chronic coryza, and even syphilitic affections of the mouth, throat, and nares, may be much benefited or even cured by the same application. It is said that five to ten drops of the fluid extract, taken by the stomach, will act favorably in the removal of the very troublesome affections named above, but the author is unable to verify these observations.

Hydrastis is very useful as a stomachic tonic, and may take the place of calumba in the treatment of atonic dyspepsia. A few drops of the tincture or fluid extract (five to fifteen) taken before meals, daily, for some time, will often cure chronic gastric catarrh, and remove the distressing headache which frequently accompanies this disease. It is one of the best remedies for the stomach catarrh of chronic alcoholism, and is probably the best substitute, if given in sufficient doses, for the alcoholic stimulant when its habitual use is to be abandoned. Catarrh of the duodenum is in a similar manner relieved by hydrastis, but this agent has special utility in duodenal catarrh when accompanied by catarrh of the gall-ducts and jaundice. Its use should, in these affections, be continued for some time.

These statements have been questioned by the authors of a dispensatory, the therapeutical part of which is chiefly remarkable for an elaborate nihilism. Quoting one of the foregoing sentences, the medical skeptic in question asserts that such confidence in the value of hydrastis indicates "marvelous virtues" in the remedy, or "still more marvelous faith" in those who make such assertions. It is unfortunate that mere library therapeutists should have the opportunity to air their crude conceptions and parade their uninstructed judgments in a big volume intended for the perusal of students and young physicians. The alkaloid hydrastine having the power to stimulate the motor centers of the nervous system, while it also acts on the gastro-duodenal mucous membrane, is peculiarly fitted to relieve that complex of conditions included in the term chronic alcoholism. It is the combination of these powers that renders it a valuable restorative when the use of alcohol is discontinued.

When constipation is dependent on deficient secretion, and the stools are dry and hard, it may be overcome by this remedy, but torpor of the muscular layer of the intestine is not affected by it.

Chronic catarrh of the intestine, even when it has proceeded to ulceration, is sometimes remarkably benefited by hydrastis. When the stools are very frequent and there is much pain, it is advantageous to combine a little opium with it. In fissure of the anus, hemorrhage from the rectum, and ulceration of the rectal mucous membrane, applications of fluid extract of hydrastis to the affected parts promote healing.

As a remedy for intermittents, hydrastine ranks far below quinine. In chronic malarial poisoning (paludal cachexia), hydrastine may be given with ferruginous preparations, as quinine is so frequently employed. Although not without action, it is inferior to quinine in the condition of enlarged spleen of malarial origin.

Late researches have shown that berberine has an injurious effect on the kidneys, and must therefore be avoided; but hydrastine may be used with advantage in certain affections of the genito-urinary organs. In chronic Bright's disease it appears to lessen the excretion of albumen. It diminishes the mucus in catarrh of the bladder. It is often a useful remedy in gonorrhoea after the acute stage has subsided, and in gleet.

Hydrastine having the power to stimulate the excito-motor functions of the spinal cord, may be expected to do much good in cases of paresis or paralysis of motility when the lesions causing them are not recent in origin. Those forms of paralysis with trophic disturbances, which succeed to fevers and other acute affections, are conditions of disease in which it may be expected to do good. Reflex neuroses having their origin in gastro-intestinal catarrh, respiratory neuroses of a paretic character, and similar maladies requiring an excito-motor, will probably be successfully treated by hydrastine.

Prof. Schatz finds hydrastis a valuable remedy in the haemorrhage of uterine myomata, in menorrhagia, in congestive dysmenorrhea, and allied states. Its power to stimulate the organic nervous system, and thus to contract the blood-vessels, is Schatz's explanation of its mode of action.

The lethal quantity of hydrastine not having been determined, the dose can not be closely stated. It is probable that, beginning with 1/20 gr., the dose may be increased up to 1/6th or even 1/2 grain.

Local Uses

Uterine and vaginal leucorrhoea, ulcerations, and erosions of the cervix uteri, are quickly improved by the topical application of the fluid extract of hydrastis, which may be used in an undiluted state.

Unhealthy and sloughing sores, chancroid, old ulcers of the leg, are improved in character by the local use of this remedy.

Authorities referred to:

Bartholow, Dr. R. Lloyd's Drugs and Medicines of North America, vol. i. Filehne, Dr. Quoted in London Medical Record, November 15, 1884. Porcher, Dr. F. Peyre. Resources of the Southern Fields and Forests, Charleston, 1869, p. 15.

Schatz, Prof. Centralblatt fur gesammte Therapie, Band ii, p. 82. Sclavatinsky, Dr. London Medical Record, supra.