and also in granular degeneration of the kidney under like circumstances. In delirium tremens, digitalis has been given in large doses, with excellent effect. It is thought that a physiological antagonism exists between digitalin and the alkaloids aconitine, delphinine and muscarine.

Administration.—Digitalis may be given in powder, of which the dose is gr. j two or three times a day, to be gradually increased. The officinal preparations are the abstract, dose, gr. ss-j; the infusion (powdered digitalis and cinnamon each 3 parts, macerated in 185 parts of boiling water for 2 hours, then strained and 15 parts of alcohol passed through the strainer, and water enough to make 200 parts), dose, fɔ̃ij-iv; the tincture, dose, mvfɔ̃j; the extract (alcoholic), dose, gr. 4, gradually increased; the fluid extract, dose, mj to begin with. If digitalis produce wakefulness, a little opium may be combined with it.

ADONIDIN.

Adonidin (not officinal) is a glucoside, obtained from the root of Adonis vernalis (Nat. Ord. Ranunculaceæ), a plant of central Europe. It was first isolated by Cervello,* and is an amorphous substance, odorless, colorless, but having an intensely bitter taste, soluble in alcohol, but slightly soluble in ether and water†.

Effects and Uses.-Adonidin is almost identical in action with digitalist, strengthening the cardiac energy, while diminishing its frequency by prolonging the diastole, thus allowing the engorged veins time to empty themselves, and at the same time raising the arterial tension by contracting the arterioles. It acts more quickly on the heart than does digitalis, and is not so apt to disorder the stomach and bowels (Cervello; Durand), although these effects are sometimes observed.

According to most authorities it possesses considerable diuretic powers, increasing both the water and the solids of the urine. It is rapidly eliminated, and has no cumulative action.

* Archiv für Experiment. Pathol. und Pharmakol., 1882, p. 338.

"Poisons; their Effects and Detection," by Alexander Wynter Blyth. Am. Ed.,

p. 396.

V. Cervello, op. cit. and La Med. Contemp., July and Aug., 1885. E. Durand, Journ. de Méd., Dec., 1885 and Thèse de Paris, 1886. Bubnow, Centralbl. für die gesammte Therapie, 1885. Houchard, Gaz. Hebdomadaire, Jan. 1st, 1886.

(Cervello). According to Hare,* in all doses it increases the arterial tension by stimulating the vaso-motor centres and increasing the force of the cardiac contractions; large doses slow the heart by stimulating the vagus, which finally becomes paralyzed, the pulse rate being then accelerated.

Adonidin may be used for the same purposes as digitalis, to which, however, it is inferior. When the latter is contraindicated from some idiosyncrasy on the part of the patient, or when it disorders the stomach, or if its action be not sufficiently rapid, adonidin may be substituted with advantage. It may, too, be alternated with digitalis, giving either for a few weeks at a time. Dose, gr. 1⁄2-1⁄2 in compressed pill or capsule.

STROPHANTUS. |

Strophantus (not officinal) is the seed of the Strophantus hispidus (Nat. Ord. Apocynaceæ), a plant distributed along the coast of Africa, between Senegambia and Lower Guinea. It is described by Blondel † as a branchy bush growing to the height of three or four metres, which gives off yellowish-white flowers, appearing in April or May, arranged in terminal cymes. The seeds are contained in a thin cylindrical pod, the length of which varies between 25 and 50 centimetres. They are from 10 to 14 millimetres in length and consist of a tiny tuft supported on a slender stalk. These seed, coarsely powdered and made into a paste, are used by the natives to poison their arrows, and are called Combé, Kombé, or Incé. From strophantus Dr. Thomas B. Fraser‡ has isolated a crystalline glucoside, which he calls strophantin, and to which the effects of the seeds are due. It is non-nitrogenous; of a strongly-bitter taste and feebly-acid reaction, and is freely soluble in water and in rectified spirits, but not in ether.

Effects and Uses—Pélikan in 1865 called attention to strophantus as a powerful cardiac poison, and his researches were confirmed by Frasers, Corville, and others. When introduced

*Therap. Gaz., Apr. 15th, 1886.

+ Bull. Gen. de Thérap., Février, 1888, p. 97.

Brit. Med. Jour., Nov. 14th, 1885.

¿ Op. cit.; also Proc. Royal Soc., 1879; Journ. Anat. and Phys., 1872; Brit. Med. Jour., Jan. 228, 1887, and a monograph by Fraser" on the action of the digitalis group," containing a reprint of foregoing articles. || Med. Digest, Sec. 393; 1, 1872.

into the system it increases the strength of the cardiac systole, while prolonging the diastole, and in over-doses arrests the heart in rigid systolic contraction. It is a muscle-poison, increasing the contractile power of all striated muscles, and renders their contractions more complete and prolonged, but the heart is easier influenced by it than are other muscles, and the dose may be so regulated that the cardiac effects are alone produced. It also contracts the arterioles somewhat, but not to the same extent as does digitalis. It produces a slight lowering of temperature and is a diuretic.* It rarely causes vomiting and has no cumulative action.

Strophantus, or strophantin has been used as a substitute for digitalis when the latter disagreed, or was objectionable from its effect in contracting the arterioles and thus throwing more work on an already overtaxed heart.

A tincture (1 to 20 parts by weight) is recommended by Prof. Fraser, of which the dose is mj−xx, t. d.

Of strophantin, gr.

may be given hypodermically.

SPARTEINE.'

Sparteine (CHN2) is an alkaloid obtained from Sarothamnus Scoparius, or Broom (Nat. Ord. Leguminosa), and occurs as a strongly alkaline, dense oily liquid, but slightly soluble in water, readily soluble in alcohol, ether and chloroform, having an intensely bitter taste and an aniline-like odor. It combines readily with acids to form salts, which are preferred for medicinal use because they are more readily soluble.

Effects and Uses.-Like the other members of the digitalis group, sparteine is a cardiac tonic, acting through the central nervous system, increasing the intensity and persistence of the ventricular contractions and regulating cardiac rhythm.†

In large doses it completely paralyzes the motor nerves and diminishes reflex action (Fick). It does not appear to affect muscular contractility. Sparteine is probably not the diuretic principle of Scoparius, and according to most observers has no effect on the urine, although Fick asserts that it increases diuresis.

Band I, p. 397.

* Bull. Gen. de Thérap., Août 23d, 1888, Lemoine. Archiv für Experiment. Pathol. und Pharmakol., Fick. Thèse, Montpellier, 1887; "La Sparteine et ses Sels," par P. Dandrieu. Gaz. Hebdom., Nov. 27th, 1885, Germain Sée, et al.

It does not disorder the stomach, has no cumulative action, and acts on the heart more promptly than digitalis (Sée). In overdoses it is capable of causing a fatal result, death being due to paralysis of the respiratory centre, and preceded by a stage of excitement, quickly followed by collapse. Poisoning from sparteine should be treated by artificial respiration and electricity applied over the vagi. When it has been taken by the mouth in the form of sulphate, potassic iodide should be administered, as in the presence of water this seems to form an almost insoluble salt (Dandrieu), and in any event elimination should be favored by diuretics and diluents. It has been used with success in cases of weak, feeble and irregular heart, particularly when the cardiac rhythm is disturbed. It has also been used as a substitute for digitalis in cardiac dropsy and in cardiac dyspnœa, but that it can fully replace digitalis in the treatment of heart affections is yet not fully established. As its action is more rapid than digitalis, it may be used when prompt results are required, and thus gain the time necessary for the influence of the digitalis to manifest itself.

The sulphate is the salt usually preferred and may be given in doses of gr. ss-ij t. d., in pill, capsule or solution. It is also used hypodermically.

CIMICIFUGA.

Cimicifuga racemosa, Black Snakerpot, or Cohosh (Nat. Ord. Ranunculacea), is a very common indigenous perennial plant, growing to the height of from four to eight feet, with ternate leaves, oblong-ovate, incised and toothed leaflets, and small white flowers disposed in a long raceme. The RHIZOME and ROOTLETS are the parts employed. The rhizome is a rugged, blackishbrown caudex, from a third of an inch to an inch in thickness, often several inches in length, furnished with numerous slender rootlets. Internally its color is whitish; it has a peculiar faint, disagreeable odor and a bitter, somewhat astringent, taste. It imparts its virtues to boiling water, and contains gum, starch, two resins, tannic and gallic acids, and a volatile oil. The active principle has not yet been isolated, nor has a crystalline proximate substance been found.*

* "Lloyd's Drugs and Med. of North America," Vol. 1, p. 266.

Effects and Uses.-The effects of cimicifuga are not very accurately known. After large doses, vertigo, dilated pupil, and often hypnotic and anodyne effects are seen. On the circulation its effects are similar to, but less powerful than, those of digitalis, as it slows the cardiac beat, while increasing the strength

FIG. 21.

CIMICIFUGA RACEMOSA.

of its contraction, and raising the arterial tension. It is undoubtedly an active stimulant of the secretions, particularly those of the skin, mucous membranes and kidneys. It acts also on the uterus and unstriped muscles like ergot, but less powerfully. It increases the sexual appetite of the male and promotes the