Fluidextractum Co1chici Seminis - Fluidextracti Co1chici Seminis - Fluid-extract of Colchicum Seed. - Dose, 1-5 minims (0.06-0.3 Cc), U. S. P.

Tinctura Colchici Seminis - Tincturae Colchici Seminis - Tincture of Colchicum Seed. - Dose, 10-30 minims (0.6-2.0 Cc).

Vinum Co1chici Seminis - Vini Colchici Seminis - Wine of Colchicum Seed. - Dose, 10-30 minims (0.6-2.0 Cc), U. S. P.

Antagonists and Incompatibles. - Alcohol and opium antagonize the cardiac depression produced by colchicum. Tannic acid and vegetable infusions containing it are incompatible with colchicine.

Synergists. - Diuretics, purgatives, emetics, potassium iodide, and alkalies promote the therapeutic activity of colchicum.

Physiological Action. - Externally and Locally. - Colchicum is a decided local irritant, and when applied to the skin acts as a rubefacient. The dust when inhaled excites sneezing.

Internally. - Digestive System. - In small medicinal doses colchicum slightly stimulates the salivary, gastric, biliary, and intestinal secretions. If these doses are repeated for several days, a sensation of heat is experienced in the epigastrium, accompanied by loss of appetite and frequently by nausea. Full medicinal doses may produce purging and colic. Larger doses occasion profuse watery and choleriform or bloody evacuations from the bowels, severe abdominal pain and tenderness, excessive vomiting - in fact, all the symptoms produced by a violent gastro-intestinal irritant.

Circulatory System. - Full medicinal or larger doses produce great depression of the circulation, with a small, rapid, and thready pulse. The marked cardiac depression and collapse which occur when poisonous doses of colchicum have been taken are more the result of the severe gastro-enteritis than of any direct action upon the heart.

Nervous System. - The nervous system is unaffected by medicinal doses. Even when poisonous doses have been taken the intellect usually remains unimpaired, though Toulmouche has seen the drug induce marked cerebral excitement. Discordant statements have been made regarding the action of colchicum upon the nervous system. The drug evidently affects different persons differently. Thus, numbness or prickling, muscular pains or spasms, and occasionally convulsions, have been noticed; yet the recent investigations of Houde-Laborde upon the action of colchicine show that it has no influence upon the centers of intelligence and volition, and does not induce paralysis of central origin, either motor or sensory, though the sensory nerves are considerably depressed.

Respiratory System. - Large or poisonous doses of colchicum render the respiratory movements slow and shallow. This action is not due to any direct effect upon the respiratory center - although Rossbach and Wehmer maintain the contrary - but reflexly to the depression occasioned by the violent action of the drug upon the gastro-intestinal tract.

Absorption and Elimination. - Colchicum is quite rapidly absorbed, and is eliminated chiefly by the bowels and kidneys, the skin sharing to some extent in the excretory process. Some observers allege that colchicum does not increase the amount of urine or the excretion of urea and uric acid, while others claim that these substances are increased.

Temperature. - Under moderate medicinal doses the temperature is unaffected, though doses large enough to produce emeto-cathar-sis are followed by a reduction of temperature.

Untoward Action. - Many symptoms described under Poisoning, have been produced by very small doses. It is a matter of speculation whether these untoward manifestations were due to a decided idiosyncrasy on the part of the patient, or to the fact that the preparation employed might have contained an unusually large percentage of the alkaloid. Recent studies point to the fact that colchicine may be oxidized in the body to oxydicolchicine, which is the active poison.

Poisoning. - The symptoms of poisoning by colchicum are violent vomiting and purging, griping and intense pain in the abdomen, precordial distress, and at times excesssive salivation, sweating, or possibly convulsions. The initial symptoms may be delayed two or three hours or even more. A great sense of depression is characteristic. This is followed by weakness of the muscles, those of the extremities seem to be partly paralyzed. While death is for a time delayed under a poisonous dose, a fatal termination is usual (90 per cent). The patient suffers excruciatingly, being little relieved by treatment, and dies of respiratory paralysis in twenty-four to forty-eight hours. The minimum lethal dose of colchicine is 40 to 60 milligrams, up to 1 grain.

Treatment of Poisoning. - All that can be done is to combat symptoms, giving opium for pain, oil and demulcent drinks for the irritation, and stimulants to counteract respiratory and cardiac depression. Washing out the stomach or the use of emetics may be required. Tannic acid serves as a partial antidote, precipitating the colchicine.

Therapeutics. - Externally and Locally. - Colchicum has no local therapeutic action.

Internally. - Colchicum is valuable for gout in all its varied manifestations. Diarrhea, dysentery, dyspepsia, bronchitis, asthma, neuralgia, and eczema dependent upon a gouty condition are singularly benefited by colchicum.

This medicine, while occasionally efficacious in chronic rheumatism, and occasionally of some benefit in rheumatoid arthritis, is of no value in acute articular rheumatism.

Its value is more apparent in acute, than in chronic, gout, and in the first attacks than in succeeding ones. Chronic gout, as well as chronic rheumatism, yields better to a combination of colchicum and potassium iodide than to colchicum alone.

In combination with certain other agents colchicum serves an excellent purpose as a cholagogue, full doses being frequently very effective in relieving ascites due to obstructive diseases of the liver. Salicylic acid or the salicylates are excellent adjuvants to colchicum in these conditions.

Colchicum is sometimes employed as a drastic purgative in cerebral and portal congestion, although when given in doses sufficient for this purpose it occasions considerable nausea and abdominal distress. It is unsafe in this connection.

In combination with certain other agents colchicum serves an excellent purpose as a cholagogue, full doses being frequently very effective in relieving ascites due to obstructive diseases of the liver.

Hypochondriasis resulting from renal insufficiency is frequently benefited by colchicum.

Contraindications. - The drug would be contraindicated in acute inflammatory conditions of the gastro-intestinal tract. It should be cautiously administered to old people.

Administration. - The liquid preparations are to be preferred, and, in order to secure the full curative effects of the drug, it is unnecessary to give it in doses sufficiently large to cause nausea. The initial dose, therefore, should be small, that it may occasion no gastric disturbance.

The beneficial effects of colchicum may be enhanced by first emptying the intestinal canal by means of a saline cathartic.

The preparations of colchicum vary greatly in strength. The crude drug contains different percentages of the alkaloid, according to the season of the year in which the plant is gathered. Owing to this variation the alkaloid is to be preferred, though, because of its activity, it should be given in very small doses at first.