CIMICIFUGA. — Black cohosh or black snake-root. The rhizome and root lets of the Cirnicifuga racemosa, a per ennial plant found in the United States and Canada, contains an acrid, neutral alkaloid, soluble in water, dilute alcohol, chloroform, and ether, and two resins, one of which, cimicifugin, is precipi tated from the tincture of cimicifuga when water is added to the latter.
Preparations and Dose.—It is impor tant that all preparations of this drug be made fresh, since they deteriorate upon keeping.
Fluid extract, 1/., drachm.
Extract, 1 to 5 grains.
Tincture (20 per cent.),1 to 2 drachms. Cimicifugin or macrotin (resin), 1/2 to 2 grains.
Physiological Action. — Cimicifuga was extensively employed by the abo rigines of North America as an aborti facient, its action in this particular greatly resembling that of ergot. It may be used when the latter drug cannot be obtained as an ecbolic, not only during parturition, but in post-parturition hmm orrhage. In moderate doses cimicifun acts as a diuretic and tends to increase the bronchial and cutaneous secretions, while in small doses it stimulates digest ive functions, acting as a bitter tonic. Its influence upon thc heart resembles that of digitalis: large doses increase arterial tension and cardiac action, while the pulse is slowed. The latter result being secondary, the use of the drug, when the walls of the organ are diseased, becomes dangerous in large doses.
Poisoning by Cimicifuga.—A typical case of poisoning which occurred in the person of a physician will best illustrate the effects of an excessive dose.
Dr. I. N. Brainard took 3 drachms of the fluid extract of cimicifuga, and the effects produced by the drug are by him described as follows: In about half an hour had a feeling of fullness in the head; the face was flushed; there was a sensation of warmth all over the body, with vertigo, which was increased when in the erect posture. There was con siderable pain at the end of the spine. After an hour had elapsed all these symp toms were accentuated. There was red ness of the eyes, but the pupils were normal, as was also the bodily tempera ture. The pulse was 100 and full, and
there was marked increase in the arterial tension. At no time was there any slow ing of the pulse or any signs of cardiac depression. The headache now became excessively severe, and the spinal cord was apparently much stimulated. The muscles in the back, arms, and legs were hard and trembling. Two hours later these symptoms continued with increased severity, and nausea then appeared. There was increased peristalsis, but no purging. Four hours after taking the poison lie' drank some warm water, and vomited three times during the next five hours. The symptoms continued, never theless, until the eighth hour. The head ache was so exceedingly severe that it was necessary for his wife to ancesthetize him with chloroform. There was a great deal of backache and restlessness. Eight hours after the drug was taken sleep came on, from which he awoke several times with marked priapism. The ef fects upon the spinal cord and nerves were felt for a little over two days. There was considerable increase of bronchial se cretion, but no increase in the urinary flow or in the secretion of the skin was noticed during the entire period of the paroxysm.
Therapeutics.—As may be surmised from its physiological properties, cimici fuga has been recommended in almost every disease, but, being superior to very few drugs which possess special proper ties of a more restricted kind, it has gradually been replaced by these. Its most marked effects are probably wit nessed in the treatment of acute rheu matism, and, according to Ringer, in rheumatoid arthritis. N. H. Bentley found the fluid extract valuable in rheu matic myalgia, while Balfour obtained considerable assistance for the relief of pain in disorders of neuralgic origin. Grouping the various results reported, it would seem to possess analgesic action, its diuretic properties tending, at the same time, to rid the economy of prod ucts of metabolism: the keynote of re lief in rheumatic disorders.