This section is from the book "A Treatise On Therapeutics, And Pharmacology Or Materia Medica Vol1", by George B. Wood. Also available from Amazon: Part 1 and Part 2.
Singular as it may seem, the painful spasmodic affections are less benefited in general by belladonna than either pure neuralgic pain, or spasmodic affections without pain. Thus, spasms of the stomach, bowels, ureters, hepatic ducts, etc., and those of tetanus, do not yield readily to belladonna, perhaps because the centres of irritation in these cases are in the spinal marrow, upon which that narcotic may exercise less power than on the cerebral centres. Still, the medicine has been used in tetanus, and in certain colicky affections, and not without favourable results. Cases are on record of its successful employment in spasmodic constriction of the bowels, with obstinate constipation, and even in ileus. As a remedy in colica pictonum, it has already been spoken of; but this is rather a neuralgic affection of the bowels, than simply spasmodic, and, moreover, probably depends more on the local influence of the lead upon the nervous tissue of the bowel itself, than upon the nervous centres. In cholera it is said to have been advantageously employed in large doses; and, independently of its use in relieving the spasms of that disease, it may possibly act favourably, by its stimulant influence over the sympathetic centres, causing a contraction everywhere of the relaxed capillaries, and thus restraining the excessive discharges.
In painless spasms, the medicine is often highly beneficial. In these affections, it not only yields relief, but serves, as in neuralgia, to make a permanent impression on the nervous centres, which sometimes proves curative; and, in like manner, may be usefully combined with the antispasmodic tonics, as quinia and various metallic salts. It will very seldom cure epilesy; but, in some purely functional cases, it is said to have had this effect, and it will often ameliorate the symptoms. The patient should be kept under its very moderate influence for a long time, with occasional intermissions; and, about the period of the expected paroxysms, it should be given more freely.
In the non-epileptic convulsions of puerperal women and children it has been highly recommended; but should not be given when in these cases there is active cerebral congestion, or any suspicion of inflammation. In infantile cases, it should be confined to the convulsions which depend on some extra-cranial irritation, such as teething or spasm of the bowels. In both instances, it is best adapted to those attacks in which there is a frequent recurrence of the paroxysms, and should be given in the interval, in order to prevent the convulsions, and not during their continuance.
On the continent of Europe, belladonna was long since used in hooping-cough, but was neglected until the practice was at a recent period revived by Bretonneau. In this country, it has been employed and highly recommended by Dr. Samuel Jackson, late of Northumberland, who gave to children two years old from the twelfth to the sixth of a grain of the extract, twice or three times a day, increasing the dose until the pupil became dilated. Dr. Hiram Corson, of Montgomery County, Pennsylvania, also used it with great success. My own experience with it is confined to a single case. This occurred in an infant, to the chest of which I applied a belladonna plaster. The child was soon afterwards attacked with convulsions, which were frequently repeated, and very alarming. It recovered, however; and the hooping-cough ceased with the convulsions. It is possible that the medicine may have cured the disease, and may not have caused the convulsions, which are not uncommon in hooping-cough; and I am disposed to think that this was really the case; for belladonna very rarely produces this effect, even in poisonous doses. The occurrence, however, deterred me from afterwards having recourse to the remedy in that disease. It is thought by some to be more efficacious in hooping-cough, when associated with sulphate of zinc.
In asthma it has been strongly commended. It has been used internally in this complaint, being given during the intervals of the paroxysms, so as to sustain a steady impression; but the most efficient method of employing it is by the inhalation of its fumes. For this purpose, the dried leaves may be smoked in a pipe, or in the form of cigars, made like those of tobacco. Great care, however, must be taken that too great a narcotic effect is not produced. This use of the remedy no doubt originated in a similar employment of stramonium, which very closely resembles belladonna in its medical properties. Another mode of using the remedy, in the same complaint, is by inhaling the vapour from a decoction either of the leaves or extract; two drachms of the former, or fifteen grains of the latter, being boiled with a pint of water. The smoking of the leaves, steeped when fresh in a strong infusion of opium and then dried, is said to have afforded relief in phthisis. As the breathing of the fumes arising from the combustion of paper, impregnated with nitre, often affords great relief in the asthmatic paroxysm, the idea occurred to M. Dauncey, an apothecary of Bordeaux, that advantage might accrue from a similar impregnation of the leaves of belladonna before being smoked. Accordingly he prepared cigars from leaves thus treated, and found them to answer the purpose intended. A solution of nitre containing three ounces is sprinkled on three avoirdupois pounds of the leaves, spread out after drying. The nitre thus penetrates the tissues of the leaves, and is left after the dissipation of the moisture. Another advantage of the preparation is that the carbonaceous matter of the smoke is consumed in the combustion. (Am. Journ. of Pharm., xxx. 404).
In muscular rigidity, the local application of belladonna has been found very useful in a number of different affections. In constriction of the sphincters of the anus and neck of the bladder, and in spasm of the urethra, it has been employed in poultice, or in the way of friction to the perineum, with the extract mixed with lard; and, in the urethral affection, it has been introduced into the passage by means of a bougie smeared with the ointment. Rigidity of the os uteri in delivery is said sometimes to yield to the local application of the extract. It has been employed externally in strangulated hernia, to produce relaxation of the abdominal muscles. M. Chrestien, of Montpellier, in France, speaks very strongly of the favourable influence of the extract of belladonna, rubbed over the surface of the tumour, in reducing the strangulated bowel. (Arch. Gen., Dec. 1865, p. 743).
Under the impression that vomiting in pregnancy is sometimes caused by irritation from a spasmodic contraction of the uterine fibres, resisting the expanding growth of the foetus, Bretonneau was induced to employ friction with the extract over the hypogastric region, and met with great success. It is unnecessary to admit his theory of the influence of the medicine, which may relieve other disorders of the uterus besides constriction of its fibres, and thus obviate sympathetic irritation elsewhere; but the fact is important. Its accuracy is confirmed by the experience of MM. Trousseau and Pidoux; and the late Dr. R. L. Scruggs, of Louisiana, employed the remedy repeatedly, with uniform success. He also succeeded, by the same method, in relieving an obstinate and distressing cough, apparently dependent on irritation from the impregnated uterus. (South. Journ. of Med. and Phys. Sci, i. 318).