Piscidia, Piscidia erythrina.

Synonym—Jamaica Dogwood.

CONSTITUENTS—

Piscidin, Resin, Oil, Calcium Oxalate.

PREPARATIONS—

Extractum Piscidiae Fluidum, Fluid Extract of Piscidia. Dose, from a half to two drams.

Physiological Action—In moderate closes, Piscidia lessens sensation, induces sleep and increases the saliva and perspiration. In toxic doses it destroys sensation, paralyzes the respiratory centers, reduces the heart's action; first increases, then diminishes arterial tension and decreases the pulse rate. It first contracts, then dilates the pupils in full overdoses. It causes dyspnea, spinal convulsions, general paralysis and death. It reduces reflex action, including tetanic spasm, by excessive stimulation of the spinal cord.

Felter and Lloyd quote Dr. Ott as giving the following concerning the physiological action of this remedy: It increases the salivary and cutaneous secretions, slows the pulse, increases the arterial tension, its action being succeeded by reduced tension, which is due to a weakening of the heart. It dilates the pupils, except when the patient is passing into a state of asphyxia, when contraction takes place. It does not affect the irritability of the motor nerves, nor the peripheral sensory nerve ending. It may cause heart failure or arrest of respiratory action. In some susceptible patients small doses produce nausea, vomiting and headache.

Dr. Harris of New York says the remedy increases dyspnea, which is followed, from sufficient doses, by respiratory paralysis.

There is drowsiness, gradually increasing; muscular relaxation; incoordination of movement; diminished reflexes; lowered sensibility; dilatation of the pupils. Toxic doses produce convulsions and a tetanoid condition caused by overstimulation of the spinal cord.

Piscidia stimulates salivary secretion, diaphoresis, and to a slight extent diuresis.

It logically follows that its usefulness depends upon its action upon the brain and spinal cord, for other remedies excel it in its effect upon the heart, lungs and glands. Furthermore, it is well to consider that this remedy has no direct effect upon the gastro-intestinal tract, and that it therefore induces no nausea, no anorexia; that it does not suppress the secretions; that it does not inhibit normal peristalsis; causes no unpleasant after-effects and produces no subsequent craving for drugs. It may therefore truly be called a harmless nerve sedative, indicated in the three following conditions: (1) spasmodic affections; (2) neuralgic affections; (3) cerebral excitation.

Administration—The agent must be given in sufficient doses and repeated. It is not active in small doses. It lacks the power of opium, but operates in the same lines as an analgesic, with desirable exceptions.

It is especially applicable in those cases where the patient cannot take opium or morphine. It does not produce toxic or undesirable effects in medicinal doses.

Specific Symptomatology—The agent, in doses of from a half drachm to a drachm, will produce quiet and restful sleep, when the insomnia is due to nervous excitement, mental worry or anxiety, and in elderly patients, neurasthenics and children.

Therapy—In susceptible patients it will control pain and relieve general distress. It is distinctly a nerve sedative, and overcomes nervous excitability and also reflex irritability. It is an antispasmodic of much power in mild cases.

If given during the course of inflammatory fever of any character, and in inflammatory rheumatism, it is a useful and grateful remedy. It does not oppose other indicated agents, and induces the often needed sleep.

In violent spasmodic cough it produces relief, and in the irritating persistent cough of bronchitis it is of service as an auxiliary to cough syrups. In phthisis it controls the night cough and induces restful sleep.

It has been highly lauded as a specific in whooping cough. The cough of phthisis will yield to the remedy under consideration when large doses of codeine have failed. In dysmenorrhea piscidia has been remarkably efficacious. A morphine habitue, taking ten grains three times daily, suffered excruciating agony at menstrual periods. An increase of two grains at each dose brought no relief. Piscidia, in ten drop doses every hour brought relief, and hitherto has proved unfailing in that particular case.

Acute intestinal colic yields to piscidia. Gall-stone colic and renal colic, while not yielding to the remedy as they do to morphine, are rendered bearable by Jamaica dogwood after an initial dose of the former. It has been used to lessen labor pains, and has been lauded by some observers as highly efficacious.

Facial neuralgia seems particularly amenable to the action of piscidia. Ovarian neuralgia and pains due to straining on the uterine ligaments in displacement and tumor, are relieved by this remedy. It seems to have a satisfactory influence on all pelvic pain.

For sleeplessness, in both sthenic and asthenic conditions, piscidia is a reliable remedy. Delirium in sthenic conditions yields to piscidia as does hysteria consequent upon uterine and ovarian disorders. Piscidia is of use in hemicrania and congestive headaches generally.

In obstetrics it controls erratic pains and conduces to quiet and rest, and overcomes rigidity by its specific relaxing or antispasmodic influence, although it does not interfere with the normal uterine contractions.

In the distress following the adjustment of fractured bones or reduction of dislocations, it is especially useful and satisfactory.

It is often applied to local painful conditions with benefit. It relieves toothache, local neuralgias, and the pain of developing felons and boils. In these cases it exhibits active anodyne properties.

It acts in close harmony with the vegetable uterine remedies, promoting the influence of cimicifuga, the viburnums, senecio, helonias, pulsatilla and dioscorea.

The American Materia Medica, Therapeutics and Pharmacognosy, 1919, was written by Finley Ellingwood, M.D.
It was scanned by Michael Moore for the Southwest School of Botanical Medicine.