Phytolacca

Phytolaccae Fructus

The fruit of Phytolacca decandra. Linné (Nat. Ord. Phytolaccaceae). (U. S. P.) Poke-berries.

Phytolaccae radix

The root of Phytolacca decandra—poke-root.

Preparations

Extractum Phytolaccae Fluidum.—Fluid extract of phytolacca. Dose, τη v— 3 j.

Tinctura Phytolaccae

Tincture of phytolacca. Dose, τη x— 3 j. (Not official.)

Composition

Claussen has obtained a neutral principle, which he has named phytolaccin, but this should not be confounded with an impure resin called by the eclectics "phytolaccin." Claussen's phyto-laccin occurs in silky, shining crystals, soluble in alcohol and ether, but not in water. A peculiar acid, phytolaccic acid, has also been found in the berries by Terail. It is uncrystallizable, but soluble in water and in alcohol.

Antagonists and Incompatibles

Alcohol, ether, opium, digitalis, etc., oppose the action of phytolacca.

Synergists

All depressing agents, the paralyzers, and emetics, contribute to the effects of phytolacca.

Physiological Actions

Poke is nauseant and emetic, and these effects occur, whatever may be the mode of administration. The emesis does not occur at once; there is a slowly-accumulating anguish; vomiting does not result for an hour, and the vomiting is accompanied with great depression. Rutherford has shown that the eclectic preparation phytolaccin has decided cholagogue property—ranking, indeed, among the most effective of the agents influencing the flow of bile.

Phytolacca lowers the rate of cardiac movement and the respiration, but does not alter the rhythm. It is a paralyzer, the loss of power occurring first in the hind extremities. The impairment of motility is not due to an action of this agent on the motor nerve or on the muscle —for the irritability of the nerve and the contractility of muscle remain unaffected when a lethal dose of phytolacca has been given. The action is on the spinal cord, chiefly on the medulla. In rabbits, violent trembling occurs, and convulsions, partly tonic, partly clonic, are produced. Death ensues from paralysis of respiration; for in frogs, when all signs of life have ceased, the heart is found to be in action, on opening the chest. In cases of accidental poisoning, convulsions of a tetanic character have been observed. Elimination takes place chiefly by the kidneys.

Therapy

Poke has been proposed as an emetic, but the slowness of the action, and the great depression of the powers of life which it causes, have prevented, and will ever prevent, its employment for this purpose.

Alterative powers have been ascribed to it, and cases supposed to be malignant have been cured; but these results were probably instances of the post rather than the propter hoc. Ulcers, cutaneous diseases, and ophthalmia, are maladies which have been reported cured. Fenner reported a case of granular conjunctivitis cured by it, and in the same issue of the journal there is an editorial note, affirming the remarkable powers of the remedy in this disease. If it really does cure this disease when given by the stomach, poke is a remedy of extraordinary value. The evidence is strong that phytolacca does possess considerable power to promote the healing of varicose and other ulcers of the leg (Tidd). A soft extract is spread on muslin, and kept applied to the surface of the ulcer. Obstinate eczema has been cured in the same way. The pain and inflammation of burns may be assuaged by the same application, and the healing greatly facilitated. How far the effect is merely mechanical does not appear.

It has long been known that phytolacca is a serviceable remedy in chronic rheumatism. But the therapeutical application of this remedy most deserving of consideration is the treatment of inflamed breasts. There seems to be no reason to doubt that phytolacca possesses the remarkable property of arresting an inflammation of the mamma, and preventing suppuration. For this purpose the fluid extract may be given internally, and the solid extract spread on a cloth and kept applied to the breast which is the seat of the inflammation. The possession of this property to prevent suppuration in the breast implies the existence of the same property in threatened suppuration in other glandular organs. As the fact is entirely empirical, and rests on no physiological action of the drug, it can only be determined by further trials whether it will check suppuration elsewhere.

Authorities referred to:

Biggers, Dr. G. W. The American Journal of the Medical Sciences, vol. lxv, p. 276. Dutcher, Dr. A. P. The Cincinnati Lancet and Observer, June, 1859. Tidd, Dr. C. H. The Clinic, vol. v, p. 253.