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.
This medicine is not known to have been employed, before it was introduced to the notice of the profession by the famous Storck, who used it in insanity, chorea, and epilepsy. It is capable of fulfilling the same indications as belladonna; that is, to relieve pain, relax spasm and muscular rigidity, stimulate the depressed cerebral centres, diminish the susceptibility of the retina, and dilate the pupil. There is not, perhaps, one of the therapeutic uses of belladonna, in reference to which stramonium might not be substituted for it, with the same or very similar results. The following, however, are the diseases in which it has actually been employed, with more or less supposed success; namely, neuralgia, syphilitic pains, rheumatism and gout, dysmenorrhoea, painful tumours and ulcers, tetanus, epilepsy, hooping-cough, spasmodic asthma, puerperal convulsions, mania, delirium tremens, and nymphomania It is also occasionally used by American oculists to dilate the pupil. To enter into a minute account of its uses in each of these affections, would be merely to repeat what has been said under the head of belladonna; and I must content myself with referring the reader to the article on that subject. But the use of stramonium in asthma deserves a more particular consideration.
The smoking of the root of Datura ferox, in the paroxysms of asthma, has long been a common practice among the natives in the East Indies. An English general officer, having derived great benefit in his own case from the remedy, was induced, on his return to England, to try the effects of the common stramonium, which he found to answer the same purpose. The remedy, having been made known, was soon extensively employed, and received the highest commendation from various respectable sources. Objection, however, was afterwards made to it, on the score that it endangered disease of the brain, and had frequently caused mischievous results. The same may be said of every active remedy. In its application to asthma, stramonium requires to be judiciously employed; but, with proper precautions, there is little or no danger; and the greatest benefit may often be obtained. In dyspnoea arising from organic disease of the heart or lungs, it can generally be productive of little good, and should not be employed unless to alleviate the affection, when dependent, not on congestion of the pulmonary organs, but on mere nervous irritation connected with the disease. Neither is it adapted to cases of gouty asthma, in which there is a disposition to translation from one organ to another, and especially, when experience has shown that there is any tendency of the disease to the brain. In such cases, by stimulating the cerebral centres, the medicine renders them a point of afflux for the gouty irritation, which may fix upon them with great violence; and, though the patient may be relieved of the dyspnoea, he is liable to die of coma. But in the pure spasmodic asthma, unconnected with any other organic disease than such as has been induced by the asthma itself, as emphysema of the lungs, for example, the smoking of stramonium is often extremely useful, and, if care be taken not to carry it too far, is perfectly safe. It is applicable only to the paroxysms, and should be confined to these, lest its influence should wear out too rapidly. The relief afforded by it is sometimes immediate and entire; the patient falling quietly to sleep, not because of the soporific effect of the remedy, but in consequence of the removal of the cause of his wakefulness. It does not prevent subsequent paroxysms, and will not cure the complaint, which, after being completely established, is seldom cured by any means that can be employed; but it is an object of great importance to mitigate the sufferings of the patient, and prolong his life, as probably may be done by preventing the rapid increase of emphysema, which is the inevitable result of the excessive dyspnoea. Unfortunately the remedy has not been found equally effectual in all cases of the disease; and, even in those in which it at first operates most effectually, though it may continue to yield relief for years, yet its influence gradually diminishes; so that at length it sometimes ceases to be felt. It is said that General Gent, who was most instrumental in introducing the remedy into England, at last suddenly died with coma from the effects of it, probably owing to his over-confidence. Either the root or the dried leaves may be used. The former should be quickly dried, cut in pieces, and beaten so as to render its texture loose. Fifteen grains may be smoked at once, and the pipe may be renewed several times a day, if necessary, care being taken to stop when any decided narcotic effect is produced. The leaves may also be used in the form of a cigar; and, as in the case of belladonna, they may sometimes be advantageously impregnated with nitre previously to being rolled into the required shape. (See page 799.) The smoke is said to cause a feeling of warmth in the lungs, which is soon followed by copious expectoration, and often by some temporary vertigo and drowsiness, and sometimes nausea. In the intervals between the paroxysms, the extract may be taken internally in such doses as moderately to affect the system.
As an external remedy also, stramonium is susceptible of the same applications as belladonna, and may be used in the same way. In the form of cataplasm, or of ointment made with the extract, it has been used in inflamed or painful tumours, irritable ulcers, rheumatism in the joints or muscles, swelled mamma, painful hemorrhoids, and irritating cutaneous affections.