The dried rhizome and roots of Veratrum viride, a plant belonging to the Northern States of the United States.

Physiological Actions

Veratrum viride is a powerful cardiac depressant. When taken in small doses the pulse is at first reduced in strength and later in frequency, being sometimes lowered to 35 or 40 a minute. The fall of the pulse is in constant proportion to dose taken. It is then soft, compressible, and may be moderately full, but any exertion may change its character and it becomes rapid, thready, small, and weak, being at times almost imperceptible. Nausea and vomiting may also be produced at this stage, with excessive muscular depression and weakness. The depressing action on the heart is the result of direct influence over the heart muscle and also over the inhibitory apparatus. The brain is not affected.

Symptoms Of Poisoning

Excessive doses of veratrum viride produce violent and alarming symptoms, but fatal results from it are rare, as vomiting is usually set up immediately. The nausea is intense and the emesis violent, the skin cold and clammy, and the pulse thread-like.

Hiccough, faintness, and vertigo, partial unconsciousness, and loss of sight may be noticed among the symptoms of poisoning. Recovery has taken place after a teaspoonful dose of the fluid extract, and, in another case, the same amount caused death.

Treatment Of Poisoning

Emesis must be encouraged, and the stomach well washed out with warm water. The patient should not be allowed to rise during the act of vomiting, but to turn to the side, and afterwards, lying on his back, with the feet higher than the head, must maintain perfect rest.

Alcoholic stimulants are used, and external heat is of importance, with gentle friction to excite the capillary circulation.

Incidental Effects

The action of the skin is increased in an indirect way by veratrum and the secretion of bile is also stimulated. The temperature is quite markedly lowered by full doses, and various incidental effects, such as a feeling of heat and prickling, restlessness, anxiety, dizziness, dimness of vision, unsteady gait, a dryness of the mouth, with thirst, choking, nausea, and vomiting, may appear after medicinal doses.

An eruption attended with itching is sometimes produced, appearing on the face and especially round the mouth. With suspension of the drug this soon disappears.

In giving veratrum, if no special orders about the pulse have been given, it should not be allowed to fall below 70. A fall below 55 is dangerous.

Preparations

Tinctura Veratri Viridis. Tincture Of Veratrum Viride

Strength 10%. Average dose,  viii-0.5 mil.

Fluidextractum Veratri Viridis. Fluidextract Of Veratrum Viride

Average dose,  iss.-0.1 mil. Norwood's Tincture is a saturated tincture and is unofficial.