(Active Ingredients. - Hydrastis contains three alkaloids: Hy-drastia, a white crystalline substance; berberia, a yellow cristalline body (found also in several other plants); and xanthopuccinia,1 also yellow and crystalline. From these, various salts have been made. In addition there is an unnamed resin. Commercially there exists an article called "hydras-tin," which is a mixture of the above-mentioned ingredients.)

1 Am. Jour. Pharm., 1875.

Physiological Action. - The toxic effects of the alkaloid hydras-tin, though not severe, are interesting, from their resemblance in some respects to those of quinine. Large doses produce noises and a sensation of rushing in the ears; they do not cause any considerable disturbance of the alimentary canal, but merely a sense of warmth at the epigastrium.

Therapeutic Action. - In Europe the hydrastis has been used for disorders of the stomach and liver, and has been highly recommended in cancer. It has also been tried in the form of an infusion, in dropsy, being considered an efficient diuretic. Dr. Barton regarded this medicine as a good alterative in disordered conditions of the mucous membrane.

For my own part, I have employed it with excellent results in ulcers of the legs, the rectum, and the uterus. I have had great success with it also in prolapsus ani and in haemorrhoids, though not greater than in headaches depending upon a constipated state of the bowels. In simple constipation referable to a sluggish state of the liver, hydrastis is likewise very valuable.

Glandular swellings frequently yield to its action, but I have never perceived that any advantage resulted from the employment of hydrastis in cancer.1

When the general system is debilitated, this medicine operates in a remarkably efficacious manner, and in its action seems not unlike quinine.

The value of hydrastis is further proved in chronic coryza, when this depends upon a syphilitic taint, and where the Schneiderian membrane is of a deeper red than is natural to that part, and when its surface is more or less studded with minute ulcerated patches, with accompaniment of profuse mucous discharge, the discharge itself varying in color and consistence, from thin, clear, and starchy to thick and greenish or yellow. In these cases, five drops of the tincture of hydrastis should be taken three or four times a day in a wineglassful of water, supplemented with the use of a lotion composed of one drachm of the tincture to eight ounces of water, with which the nose may be either bathed or syringed three times a day. This treatment will quickly set up a healthy action in the mucous membrane, and remove the troublesome and tedious disease to which I am referring.

Similar treatment will be found successful in cases of ulceration of the septum or any portion of the nasal fossae.

Ophthalmic Cases. - In muco-purulent inflammation of the conjunctivae, implicating the Meibomian follicles, and causing adhesion of the lids in the morning, a lotion prepared from hydrastis is likewise very serviceable. In cases also of catarrhal ophthalmia implicating the mucous membrane of the nose and throat, I have used a douche spray of hydrastis with good effect.

Inflammations. - Catarrhal inflammation, commencing in the duodenum and spreading up the bile-duct, is often cured by a steady course of hydrastis, while the jaundice which so often attends this affection is often rapidly removed.

Inflammation of the gall-bladder and of the gall-duct, caused by gallstones, is also reduced by hydrastis, and a larger space is thereby allowed for the exit of the calculi.

Gonorrhoea. - Gonorrhoea is cured in many instances by employing

(1 Kidd (Laws of Therapeutics, Lond., 1878) has recently reported some facts that give hydrastis a renewed interest in this connection.) a lotion of hydrastis, one or two drachms of the tincture being added to a pint of water, and a syringeful injected up the urethra at first every half hour for a period of seven or eight hours; and subsequently, or for the ensuing two or three days, once every six or eight hours. (We prefer the infusion of hydrastis (3 j. of powdered root to boiling water.) When cold, niter or inject three or four times a day in ordinary cases. As the infusion contains none of the irritant resin, it is better borne than an alcoholic preparation. In subacute cases and in gleet "hydrastin" (gr. 1/2 - j. to f of water) may be used. The patient should be warned that the solution stains the linen.)

Hydrastis Hydrastis Canadensis 1Hydrastis Hydrastis Canadensis 2

Ulcers. - The chronic indolent ulcer so commonly met with upon the lower part of the leg is amenable to treatment with hydrastis, the lotion being applied externally, and the tincture given in a suitable dose.

Quite recently I have treated two cases of ulcer, one upon the nose and the other upon the eyelid. Both were of the type of the true rodent ulcer, so well described by Sir James Paget, - "The base of a dingy reddish-yellow color, dry, glazed, and free from granulations, and the discharge but slight." Both were cured by the treatment adopted in the case of the chronic indolent ulcer.

Cracks, etc, of the Nipple. - During lactation we frequently have to deal with cracks, fissures, and abrasions of the nipples. In such cases I recommend the use of a compress dipped in a lotion prepared from hydrastis, the compress to be renewed every four hours. While this treatment of the nipples is being prosecuted, the infant should be admitted to the breast not oftener than once every four or six hours, and the nipple itself should be protected with a calf's teat, so as to serve the double purpose of guarding it from injury by the child, and of defending the mouth from any consequences that might arise from direct contact with the hydrastis.

Haemorrhoids. - Internal haemorrhoids, which cause great prostration of strength, and are generally accompanied by various dyspeptic symptoms - usually giving rise to considerable pain during defecation, frequent and periodic attacks of bleeding, with a discharge from the anus of a considerable amount of mucus or of muco-purulent matter - are cured, or at all events relieved to a very material extent, by the use of hydrastis. In these cases a weak infusion should be employed as an injection every night and morning, and during its use the patient should take five drops of the tincture in a wineglassful of water three or four times a day.

In cases of external piles, hydrastis is also of great value, the lotion being used three or four times a day; or the drug may be applied equally well in the form of ointment.

Prolapsus of the Rectum. - Simple prolapsus of the rectum, occurring in children, yields to hydrastis, which in these cases relieves the congestion and the swelling of the mucous membrane, and hinders its protrusion. Now and then the prolapsus even of adults is successfully overcome by the same treatment, the form of exhibition in either case being lotion or enema, as circumstances may dictate. (It has also been found useful as an injection in fistula in ano.)

Miscellaneous Cases. - Lastly I may remark that hydrastis is a capital agent in cases of erosion and ulceration of the cervix uteri; and, in addition, it must not be overlooked that in America the alkaloid hydras-tia has been strongly recommended for intermittent fevers, for typhoid fever with copious sweats, also for excessive diarrhoea, and tendencies to septic poisoning: the dose is from two to nine grains. It has also been employed in sunstroke and in chronic dyspepsia. In the shape of an ointment (one part to six or seven) or in a lotion (one part to fifty), it has been extensively used in a great variety of ulcerative affections of mucous membranes, and apparently with very good results. It is very necessary not to confound the alkaloid hydrastia with the resin called hydrastin, obtained by a different process from the root: the latter is a pale, straw-colored powder with a pure, bitter taste; it has purgative qualities, and is recommended in the constipation of old persons in doses of three or four grains.

Preparations And Dose. - The fluid extract is officinal. Commercially there are tinctures and fluid extracts from the dried and a tincture from the fresh plant; also the alkaloids hydrastia, and berberia, and their salts, and the mixed product hydrastin. The dose of the powdered root as a tonic stomachic and anti-dyspeptic is from gr. v. - x. (.30-.65), two or three times daily. The tinctures and fluid extracts in proportional quantities. The usual dose of hydrastin is gr. ss.-ij. (.03-. 12).