Under this name, the U. S. Pharmacopoeia recognizes the root or rhizome of Veratrum viride, variously called American hellebore, swamp hellebore, Indian poke, etc., an indigenous perennial, growing abundantly in wet, low, or swampy places, in most parts of our country from Maine to Georgia. The root should be collected in the autumn, after the fall of the leaf, and, as it is injured by time, should not be kept longer than a year.

Properties

The body of the root or rhizome is fleshy, somewhat more than an inch long by an inch in thickness, coated with membranous coverings above, and thickly invested beneath with numerous whitish or yellowish fibres or rootlets. in the recent state, it has a disagreeable odour, which is lost by drying. its taste is bitter, with an unpleasant acrimony, spreading through the mouth and fauces, and very durable-it imparts its sensible properties to water and alcohol; but its virtues are impaired by heat, and appear to be destroyed by long boiling; as Dr. Osgood found an extract prepared from the decoction nearly inert. it might be inferred from the botanical relations of the plant, and from the similarity of its effects to those of Veratrum album, that it owes its activity, at least in part, to Veratria; and Mr. J. G. Richardson, of Philadelphia, believed that he bad found this alkaloid among its constituents. (Am. Journ. of Pharm , xxix 204.) But, from more recent investigations, there is good reason to believe that there are three active constituents in veratrum viride; two of which are alkaloids, and the third a resinoid neutral substance. Of the two alkaloids one is soluble, the other insoluble in ether. The former of these is the one which, from the close resemblance of its properties to those of Veratria, has been supposed to be identical with that alkaloid; though, from the latest experiments on the subject, by Mr. Charles Bullock, of Philadelphia, it would appear to be different in some respects; so that though closely analogous, it cannot be considered as absolutely identical. The alkaloid insoluble in ether may be separated, in notable proportion, from the resinous matter thrown down when the tincture of the root, or an alcoholic solution of its spirituous extract, is dropped into water acidulated with sulphuric acid. According to Mr. Bullock, this peculiar alkaloid has, when swallowed, a very decided effect in diminishing the frequency of the pulse, without causing nausea or any other untoward effect in the dose administered; so that it is positively sedative, independently of any nauseating influence. (Am. Journ. of Pharm., March, 1866, p. 98.) The resinoid matter, prepared in the mode above described, was ascertained by Dr. Sam. R. Percy, of New York, by repeated experiments on dogs, to have a powerful sedative influence on the circulation, and, in like manner with the alkaloid referred to, as having been separated from it by Mr. Bullock, without necessarily nauseating or vomiting; nevertheless, in large doses, it is capable of producing both these effects. (Prize Essay by Dr. S. R. Percy, published in the Transactions of the Amer. Med. Assoc, a.d. 1864) But a singular result of Mr. Bullock's researches is that this resinoid body, when entirely freed from the alkaloid contained in it, has still precisely the same physiological effect; and it appears to me highly probable, that it will ultimately be found to be a neutral compound of this same alkaloid, held so strongly in combination by the neutralizing acid that no method hitherto tried has proved successful in separating them.

Effects on the System

American hellebore bears so close a resemblance in its effects to the medicines belonging to this class already described, that it could not with propriety be separated from them in any system of arrangement. Like them it is locally irritant, in its general action sedative to the nervous system and circulation, and more or less stimulant to the secretions. For a knowledge of its physiological effects, we are mainly indebted to Dr. Charles Osgood, of Providence, Rhode island, who appears to have had his attention directed to the subject by Professor Tully, of Yale College, by whom the medicine had long been habitually employed, and recommended in his lectures. The results of his investigations were made known in a communication published in the American Journal of the Medical Sciences for August, 1835 (xvi. 296). His statements have since been amply confirmed by others, and especially by Dr. W. C. Norwood, of Cokesbury, S. C, who deserves the credit of having aroused the attention of the profession to the subject, and of having thus given much greater extension to the use of the medicine than it had ever before received.

Locally applied, American hellebore is capable of producing irritation, rubefaction, and even vesication of the surface. Snuffed into the nostrils in the form of powder, even much diluted, it acts as an errhine and sternutatory. its acrid impression on the mouth and fauces, when chewed, has been already mentioned. When swallowed, it is apt to cause uneasiness in the epigastrium, which, when the dose is sufficiently large, is followed by nausea and vomiting, the latter effect being often protracted, and attended with much retching, and sometimes with hiccough. Dr. Osgood noticed, in his own case, that the vomiting was effected by a spasmodic contraction of the stomach itself, without participation of the diaphragm and abdominal muscles; and, in another individual, was preceded by a sensation as of a ball rising in the oesophagus, the result no doubt of a spasmodic contraction of that tube. The antecedent and attendant nausea does not seem to be severe, though the prostrating effects on the system, as will be more particularly noticed directly, are often very striking. The emesis is usually later in occurring from this than from other emetic medicines; three-quarters of an hour or more not unfrequently elapsing, after its exhibition, before this effect is experienced. A fact which, considering the drastic properties ascribed to veratrum album, was not anticipated, but which appears to have been confirmed by almost all who have reported their experience upon the action of the medicine, is that it seldom if ever purges. The remarks hitherto made have reference to its local operation. its effects on the system are even more striking.