VERATRUM VIRIDE.—Veratrum viride (U. S. P.), or American helle bore consists of the rhizome and roots of Veratrum viride (Indian poke, poke root, or swamp-hellebore; nat. ord., Liliacecc): a plant indigenous to the United States. This remedy should not be confounded with phytolacca, which yields the officinal poke-berries and poke-root. Veratrum viricle con tains a number of principles, the chief of which are, however, jervine and vera troidine, which are so closely associated with the resin as to be separated from it with great difficulty.
Preparations and Doses. — Veratrum viride (U. S. P.), 1 to 5 grains.
Extra ctum veratri viridis fluidum (U. S. P.), 1 to 5 minims.
Tinctura veratri viridis (U. S. P.), 1 to 5 minims.
Physiological Action. — Veratrum vi ride is a powerful spinal and arterial depressant, exerting little or no direct influence upon the cerebral centres. In full therapeutic doses it lowers the pulse rate both by a direct action on the mus cle (jervine) and by stimulating the in hibitory nerves (veratroidinc); it dimin ishes the force of the heart-beat by a direct influence upon the cardiac muscle (jervine), and produces a general vaso motor paralysis (jervine) more or less complete, according to the doses. Under its action the functional activity of the skin is greatly increased; but, as this is a necessary result of the profound arte rial impression, there is no reason for be lieving that the drug has any specific influence upon the perspiratory glands. In a similar manner the excretion of bile is often indirectly increased by veratrum viride, through the excessive vomiting which it induces (H. C. Wood). The temperature is lowered very decidedly by this drug, but whether directly or indi rectly has not been determined.
Poisoning by Veratrum Viride.—An overdose of this drug is followed by a sensation of burning and pain through out the alimentary tract and an in ability to swallow, accompanied with vomiting and diarrhoea; palpitation; slow, weak pulse; and labored respira tions. The pupils are generally dilated.
Convulsions may be present. Death may occur through paralysis of the respira tory centres. Overdoses of it provoke vomiting so soon and so certainly that it is somewhat doubtful whether a robust adult could be killed by a single dose of any of its official preparations, especially if prompt and judicious treatment were afforded. Alarming symptoms may, how ever, result from large medicinal doses repeated at short intervals, but they gen erally yield promptly to treatment.
Treatment of Poisoning by Veratrum Viride.—In cases of poisoning by vcra trum viride Wood states that "vomiting should be assisted by copious draughts of warm water until the stomach is well washed out (lavage by means of stomach siphon may be used). The patient should then be made to lie flat upon his back, with the head lower than the feet, and all efforts at vomiting should be re strained. If they cannot be checked, and if the prostration be severe, on no ac count should the patient be allowed to rise up, but must be made to vomit into a towel. A full dose of laudanum should be given by the rectum, and brandy or whisky be administered by the mouth. If the stomach refuses alcohol in any shape, the rectum should be made use of. Ammonia may be employed as an adjuvant to alcohol, and in extreme cases may be injected into a vein. Amyl-ni trite inhalations are said to have been of service. External heat is important, and mild flagellations, rubbing with coarse towels. sinapisms, etc., may be used to keep up external capillary circulation." Atropine, alcohol, opium, coffee, hypo dermics of ether and of strychnine, car diac and respiratory stimulants, extreme heat, and the head placed low are sug gested by others.