Veratrum viride. American Hellebore.

In many parts of the United States the swamps and wet meadows, which have been converted into mowing lauds, are peculiarly marked in the early part of spring by two species of plants. These are the Ictodes foetidus already described (Pl. xxiv) and Veratrum viride, usually denominated Poke root and Hellebore. Both of these plants spring up more rapidly than the grass around them, and from the largeness and bright green colour of their leaves they are often the most noticeable objects in the places of their growth. As the season advances, the Ictodes continues only a tuft of radical leaves, while the Veratrum sends up a straight leafy stalk, which frequently acquires the full height of a man.

This plant is not only found in boggy meadows, but by the sides of brooks in rocky and mountainous situations, from Canada to Carolina. Its flowering time is from May to July.

The Veratrum album or White Hellebore, a well known medicinal plant found in most countries of Europe, has a very close resemblance to the American species. It is, however, a smoother plant, and differs somewhat in its flowers, bractes and stalks.

The genus Veratrum, on account of the diversity of its flowers, was placed by Linnaeus in his class Polygamia and order Monoecia. Those more recent botanists, who omit this class, have transferred the genus to Hexandria trigynia.

The generic character of Veratrum consists in a six-parted corolla without calyx. Stamens inserted in the receptacle. Capsules three, many seeded. A part of the flowers barren. The species viride has a downy panicle with the partial bractes longer than their pedicels. Segments of the corolla thickened on the inside at base.

The root of this plant is thick and fleshy, its upper portion tunicated, its lower half solid and sending forth a multitude of large whitish radicles. The stem is from three to five feet high, roundish, solid, striated and pubescent. Throughout the greater part of its length it is closely invested with the sheathing bases of the leaves. The lower leaves are large, from half a foot to a foot long, oval, acuminate, pubescent, strongly plaited and nerved; the lower part of their edges meeting round the stem. The upper leaves become gradually narrower and the uppermost, which perform the office of bractes, are linear-lanceolate. The flowers are numerous and distributed in compound racemes axillary from the upper leaves, and terminal; the whole forming a sort of panicle. Peduncles roundish, downy. Bractes boat-shaped, acuminate, downy. The pedicel of each flower is many times shorter than its bracte. Calyx none. Corolla divided into six green, oval, acute, nerved segments, of which the alternate ones are longest. All the segments are contracted at base into a sort of claw with a thickened or cartilaginous edge. Stamens six with recurved filaments and roundish, two-lobed anthers. Germs three, cohering, with acute recurved styles as long as the stamens. A part of the flowers are barren and have only the rudiments of styles, so that the plant is strictly polygamous. The seed vessel consists of three capsules united together, separating at top and opening on their inner side. Seeds flat imbricated.

The root of the Veratrum has a bitter taste accompanied with acrimony, and leaves a durable impression on the mouth and fauces when it has been chewed or swallowed. It abounds with a resinous juice, which adheres closely to a knife with which the root has been cut. This resin dissolves abundantly in alcohol. When water is added to the solution, a white turbidness gradually appears rendering the liquid opaque, but without sediment. The decoction has an intensely bitter taste. It is not rendered turbid by alcohol although some slight flocculi are separated after standing. It is probable that this bitterness resides in an extractive principle. The distilled water of the root has a slightly unpleasant taste, without bitterness or pungency.

This plant in its medicinal powers resembles the Veratrum album or White hellebore of Europe. It is an acrid emetic and a powerful stimulant, followed by sedative effects. As a medicine or as a poisonous plant, it has been known from an early period. The aborigines of the country were fully apprized of its activity. Josselyn in his voyage to New England, which took place not long after the first settlement of the country, informs us that the young Indians had a custom of electing their chiefs by a sort of ordeal instituted with the roots of this plant, which he denominates "white hellebore." A portion of this root was repeatedly given to each individual, and he whose stomach made the most vigorous resistance or soonest recovered from its effects was considered the stoutest of the party and entitled to command the rest.

Kalm tells us that the people of this country, at the time of his travels, employed a decoction of this plant externally in the cure of scorbutic affections, and for the destruction of vermin. He further states, that corn before planting was soaked in a strong decoction of the Veratrum to protect it against the birds which infest our fields and devour the grain after it is deposited in the ground. When the corn is thus prepared, it is observed, that those birds which swallow it become giddy and fall to the ground, an example, the writer informs us, which has the effect to frighten the remainder of the tribe away from the place.

Since the celebrity acquired by the European white hellebore as a remedy for gout, that plant being for a time supposed the basis of the celebrated Eau medicinale; the attention of some practitioners has been turned to investigating the properties of the American plant, which so closely resembles the Veratrum album in its external habitudes. The result of such trials as have been made, establishes beyound a doubt the medicinal similarity of these two vegetables. I have employed the American plant in dispensary practice in the treatment of obstinate cases of chronic rheumatism. Other practitioners have applied it to the treatment of gout, and of cutaneous and other affections. From the sum of my observations and knowledge respecting it, I am satisfied that the root, when not impaired by long exposure and age, is in sufficient doses a strong emetic, commencing its operation tardily, but continuing in many instances for a long time; in large doses affecting the functions of the brain and nervous system in a powerful manner, producing giddiness, impaired vision, prostration of strength and diminution of the vital powers. Like the Veratrum album and Colchicum antunmale, the violent impression which it makes upon the system has arrested the paroxysms of gout and given relief in some unyielding cases of protracted rheumatism. Like those substances, it requires to be given with great caution and under vigilant restrictions. The solutions of this article have appeared to me more powerful in proportion to their quantity than the substance, probably in consequence of a part of the powder being thrown out in the first efforts to vomit, before a perfect solution of its active parts in the stomach could have taken place.

A course of experiments with this article was made sometime since in the Boston Almshouse by Dr. John Ware, the results of which he has obligingly communicated to me. They cannot be better stated than in his own words. "I gave this plant," says he, "in the first place with a view to ascertain its action on the stomach and alimentary canal. The doses in which it was administered amounted to from two to ten grains. I began with a small quantity, and increased it very gradually in order to guard against the occurrence of those violent and dangerous effects which I had been led to apprehend from the descriptions given of the operation of the white hellebore. A slight and general account of the experiments will give the most satisfactoiy view of the effects of this root as an emetic.

"It was administered in about thirty cases. In the first case two grains were given; this only produced slight and temporary nausea.

"In three instances three grains were administered; in two of these vomiting was produced; in one of them to a considerable degree—in the other slight—in the third no effect whatever was produced.
Of gr. iv. Four doses, of which only one operated, and then the operation was inconsiderable.
Of gr. vi. Fifteen doses were given—ten of these operated perfectly well; as complete and thorough vomiting was produced as follows from the case of any other emetics—in the eleventh case nausea only ensued—and in the remaining, no effect whatever was perceived.
Of gr. viii. Four doses—of these, two failed entirely and two operated satisfactorily.
Of. gr. x. Only one dose was given—this operated very thoroughly.

"I did not find, as I had expected, that this substance was uncommonly violent or distressing in its operation. Patients, in general, did not complain of any thing unusual, and when they were particularly questioned as to their sensations, they told of nothing more than those usually occurring during the effects of a brisk emetic. It seemed to produce vomiting rather more severely than an ordinary dose of ipecac—but not more than one of antimony. Indeed, its operation may fairly be said to be about as violent and distressing as that of any other emetic whose effects in evacuating the stomach are equally thorough. In a few instances, however, there was a complaint of very violent and painful retching—and of dizziness at the time and for a short time after—still these effects were not common nor excessive.

"As to its influence as an emetic upon diseased states of the system, there were few opportunities of administering it where any considerable derangement existed. In those cases which did occur it did not appear to be inferior to the common emetics.

"The degree of operation did not seem to be much increased by the increase of the dose of the medicine. Doses of six grains appeared, when they took effect, to produce vomiting as thorough and complete, as that which followed from larger doses; except that the larger were perhaps more speedy in operating. I could find no cause for the failure of so many of those cases in which the dose amounted to six or eight grains, except an insensibility in the patient to the stimulus of the medicine; and this was rendered more probable from the circumstance that generally in those instances, the substance failed in producing any effect whatever; nausea did not often occur when vomiting was not to follow it, and in no instance was it very clear that purging was produced.

"Indeed this appeared to be rather a singular circumstance relating to this substance, and one in which it differs from most or all other emetics. These articles, when they fail of producing vomiting, generally occasion a determination downwards, and thus produce all the phenomena of cathartic medicines. This effect is also frequently produced when they have operated in their peculiar way. But in no instance did this appear to be the case with the Hellebore. Some patients, indeed, said that it operated upon them by stool very slightly—but on strict inquiry I did not think that the medicine had had any effect in this way, and that what was told me proceeded from a desire in the persons to attribute some sort of effect to what had been given them.

"In the greater number of the cases, the Hellebore was longer before it produced vomiting than is the case generally with other emetics. It did not often operate in less than three quarters of an hour or an hour—but sometimes the interval was extended to two or three hours—and in one case, although the dose was administered at twelve at noon, its effects were not produced until between nine and ten o'clock in the evening. This tardiness in manifesting its effects on the system corresponds with what has been observed with respect to the European species.

"I made a few experiments with the powder of the Veratrum album in order to compare its powers with those which existed in our native species. It was given in six cases—of two doses of three grains—neither produced any effect—one of four was not more effectual—six grains produced some vomiting, but not to any considerable extent—seven no effect whatever—and eight produced in about four hours after taking it considerable effect. If these experiments are to be depended upon, the foreign certainly is not more powerful than the native species.

"I endeavoured next to ascertain what degree of power the Hellebore was possessed of over cutaneous diseases. It has the reputation in the country of some efficacy in these complaints. The ointment and decoction were applied in a number of cases, and it certainly proved to be an application of considerable power. Its effects in some cases amounted to a removal of the disease entirely—and in most, some diminution of it followed, which was more or less durable.

"In one case where there was an eruption about the wrists and other parts of the body, supposed to be the itch—the ointment (made by simmering together a dram of Hellebore in an ounce of lard) after being applied for some time, removed the disease. The cure, however, was protracted and tedious.

"A second case was that of a boy who had on the back of his head, what appeared to be the commencement of Tinea capitis. The ointment made in the same way as that before mentioned, except that simmering was omitted, removed it in the course of a fortnight. It returned again in the course of a few weeks and was again destroyed by the same application. It did not recur so long as I had an opportunity of observing the child, which was, however, not long.

"In one clear case of itch, the ointment failed of producing any beneficial effect, and it was necessary to have recourse to the usual remedy.

"An instance of a very troublesome and irritating eruption upon the hands and fingers, accompanied by a venereal taint of the system, was very much relieved by this ointment. Its final removal, however, could not be attributed to this, since the patient was under the influence of mercury at the same time.

"In some other cases both the ointment and decoction were used with success for a time, but the effects they produced were only partial and temporary."

Of the power of this plant to relieve the formidable disease of gout, we have the most satisfactory evidence. A composition intended to imitate the celebrated Eau medicinale was prepared in England by Mr. Moore from the wine of white hellebore and wine of opium in the proportion of three parts of the former to one of the latter. This compound was used by many arthritic patients both in Europe and America with great success in relieving the paroxysms of the disease. In Boston a considerable number of individuals have been induced to make trial of the remedy, and generally with advantage. But I am informed by several of our most repectable apothecaries, that for a long time, especially during the late war, when the white hellebore could not be obtained from Europe, the American plant was used in the preparation of the medicine upon the supposition of its being the same with the European. Various gouty patients mane use of it, and no difference was perceived by them of their physicians in its mode of operation or effect upon the disease. Some were relieved by small doses, which did not even nauseate, such as fifteen or twenty drops, repeated if necessary. Others found a drachm of the mixture necessary, which quantity affected them unpleasantly by vomiting or otherwise. Some experienced such severe effects as to deter them after one trial from a repetition of the experiment. In general the paroxysm of gout was completely suspended by the operation of the medicine.

On the whole, we have sufficient knowledge of the American green hellebore, to feel assured that it is a plant of great activity, closely resembling in its properties the Veratrum album of Europe; and that like that plant it has given relief in the paroxysms of gout and in rheumatism. Whether the original Eau medicinale be a preparation of Veratrum, Colchicum, or any other acrid narcotic, it is not of consequence here to decide. These plants, with several others that might be mentioned, are similar in their operation, and probably influence the system when under disease, much in the same way. Some individuals obtain relief from moderate doses, which do not occasion nausea or any very disagreeable effects. Others have not derived benefit except from such quantities as bring on vomiting. Some have experienced very distressing consequences, such as excessive sickness, purging, great prostration of strength, impaired vision, and even total insensibility, where the dose has been imprudently large.

The wine of green hellebore is prepared like that of the white, by infusing for ten days eight ounces of the sliced root, in two pints and an half of Spanish white wine. Before being given, in gout, it is combined with one fourth part its quantity of wine of opium. Of this compound the dose varies from twenty drops to a drachm.

From some observations made by Sir Everard Home respecting the wine of Colchicum autumnale, it is probable that the wine of Veratrum may be less violent in its effects, if freed from the sediment which it deposits by standing.

Of the substance of the root freshly powdered, from two to six grains will be found a sufficient dose. For medicinal use, however, in most cases it is probable that the liquid preparation above described promises more.

The external application of the ointment and decoction sometimes produces the same effect on the stomach as the internal use of the plant. In one instance a patient was nauseated and vomiting brought on by the ointment applied to an ulcer of the leg. I have known similar consequences from a strong decoction in cutaneous affections. Might the topical application of this plant be of any service in gout?

Botanical References.

Veratrum viride, Aiton, Kew. iii. 422.
Willdenow, Sp. pl. iv. 896.
Pursh, i. 242.
Rees' Cyclopedia, ad. verb.
Veratrum album, Michaux, ii. 249.
Helonias viridis, Bot. Mag. 1096.

Medical References.

Kalm, travels, ii. 91.
Josselyn, Voyage to New England, p. 60.
Thacher, N. Eng. Journal.

American Medical Botany, 1817-1821, was written by Jacob Bigelow, M. D.