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.
Henbane was known as a medicine to the ancients, but received little notice, until attention was attracted to it by Baron Storck, of Vienna, so famous for his experiments with this and other narcotics, and for the enthusiastic estimate he placed upon their therapeutic powers. Though this medicine has not realized all that was hoped from it, in consequence of his representations, it is, however, of no little value, and assuredly does not deserve the sentence of banishment from the Materia Medica pronounced upon it by M. Fouquier. (Arch. Gen., i. 297 and 312).
The indications which hyoscyamus is calculated to fulfil are to allay pain, produce sleep, relax spasm, and quiet nervous disturbance generally. These are, among others, the therapeutic effects of opium, which hyoscyamus probably as nearly resembles, in its soporific influence, as any other medicine. It is, however, in these respects, much inferior to opium, and incomparably less to be relied on; but there are certain circumstances under which, in consequence of its want of properties which sometimes interfere with the beneficial operation of that medicine, it may be used when opium cannot, and is admirably calculated to supply its place. In the first place, it is much less stimulant to the cirof the blood, which throws out the noxious matter before time has been allowed for it to accumulate so as to be destructive. But if one of the solanaceous alkaloids be injected into the veins, or even into the subcutaneous tissue, it acts on these animals poisonously, just as it acts on man. (Note to the third edition).
In fevers, hyoscyamus may often be usefully employed to quiet nervous disturbance and produce sleep, where the excitement may be too high for opium, or that medicine may be objectionable upon some one or more of the grounds just mentioned. This remark is especially applicable to the febrile affections of infants, in which a little hyoscyamus may often be advantageously conjoined with the refrigerant or laxative medicines, when there is considerable nervous disturbance, inquietude, and wakefulness; while opium might do more harm than good.
In the different phlegmasiae, also, the medicine may be used to fulfil its proper indications, with no little benefit. This is particularly the case in bronchial inflammation, whether original, or connected with other diseases, as measles, pneumonia, etc., in the earlier stages, before secretion has taken place, and in any stage, whether acute or chronic, if the prominent indication is to promote secretion, and to allay cough. Opium might fulfil the latter indication at the expense of the former. Hyoscyamus, if it do not fulfil both, has certainly no effect in restraining the secretion. It should be combined with the expectorants employed. The same may be said of its use in hepatitis, especially when the substance of the gland is affected. In the peritoneal form of hepatitis, opium would be incomparably superior. In nephritis, when there is a great deficiency of secretion, hyoscyamus may sometimes be pref-able; and for the same reason, applying, however, in this instance to the mucous and not the urinary secretion, there may be instances in which this narcotic would be more appropriate than opium in inflammation of the bladder and urinary passages.
To the relief of the more violent forms of neuralgia, or indeed of excessive pain from any cause, the anodyne powers of hyoscyamus are generally inadequate; though it may be tried in any case of the kind where opium cannot be given. There is, however, one condition of things in which it is peculiarly indicated; I refer to attacks of excessive sensitivess of the retina. A case of this kind occurred to me, many years since, which will illustrate my meaning. A gentleman of highly nervous temperament, in the state of general depression following an acute disease,and after considerable depletion, was seized with an exquisite irritability and sensitiveness of the eye, which occasioned the most severe suffering. Light was torture to him; and it was necessary to close the outer shutters of the apartment, and to draw the curtains closely around his bed. so as to prevent the least particle from reaching him. Notwithstanding, however, this precaution, he complained of the intolerable brightness, the intense and insufferable glow, as of incandescent metal held immediately before his face, or of a concentration of the whole blazing light of the sun directed upon his vision; and language. in one who knew its resources well, and knew how to wield them powerfully under the impulse of a brilliant imagination, was exhausted to find expressions strong enough to convey an idea of his sufferings. Under the impression that he was affected with inflammation of the eye, he refused opiates altogether, though urged upon him. At last I prevailed on him to take a single grain of extract of hyoscyamus every hour. He had not taken more than three or four doses, when he experienced a sensible amelioration of his sufferings, along with the first narcotic impression of the medicine; and they continued to abate so long as the hyoscyamus was used. Convinced now of the nature of the affection, he consented to take an opiate enema, which immediately put an end to the symptoms. I have no doubt that a full dose of the byoscyamus would have had the same effect. It is especially indicated in neuralgic affections of the eyeball, through its influence over the nervous centre of vision.
In carcinomatous and other painful organic affections, hyoscyamus may be alternated with opium, in the hope of protracting longer the period of susceptibility to the anodyne effect of the latter remedy.
Spasmodic and convulsive diseases, and other forms of nervous irritation, afford frequent occasion for the use of this narcotic. It can do little good in the more violent cases of painful spasm, such as spasm of the stomach, severe colic, the cramps of cholera, tetanus, etc; yet in the milder conditions of the affection it may often be usefully combined with Other medicines, as in slight colicky pains with cathartics, in the milder forms or stages of colica pictonum with alum, in similar conditions of the biliary and urinary passages with calomel in the former case, and bicarbonate of soda in the latter. In asthmatic affections, pertussis, and the convulsive attacks of infants dependent on teething or intestinal irritation, it may sometimes be advisable. Though inadequate to the cure of epilepsy or chorea, it may be usefully combined, in some instances, with the metallic tonics and nervous stimulants used in those complaints. In the multiplied nervous disorders of hysteria, hyoscy-amus may now and then be had recourse to, with great benefit, for relieving distressing sensations, soothing inquietudes, and procuring sleep.
It is a favourite practice with many to combine hyoscyamus with the more irritating purgatives, under the impression that it tends to prevent their griping, without diminishing their purgative effects. For this purpose it is frequently used with the compound extract of colo-cynth, or with scammony, colocynth, and aloes severally.
Contraindications to the use of hyoscyamus are active congestion or inflammation of the brain, a very high degree of febrile or inflammatory excitement generally, and inflammation of the stomach or bowels.
Topical Use. Fresh henbane is sometimes used in the form of a cataplasm, or infused in hot water as a lotion or fomentation, to relieve pain and irritation, as in hemorrhoidal or carcinomatous tumours, painful glandular swellings, gouty or rheumatic affections, scrofulous and cancerous ulcers, nervous headache, etc. The extract is also employed for the same purposes. The remedy is sometimes used in the way of enema, to relieve irritation of the rectum, bladder, urinary passages, or genital organs. Oculists sometimes use it to dilate the pupil before the operation for cataract; a solution of the extract, or an infusion of the leaves being dropped into the eye, or the extract with lard, rubbed upon the lids and around them The effect is usually produced within four hours, and continues twelve. The same application has been recommended after the operation for cataract, when there is danger of iritis, to prevent the pupil from closing. Used in this way, it does not affect the vision.