Cactus. Cactus grandiflorus.

Synonyms—Selenicereus grandiflora, Cereus Grandiflorus (Haworth); Night-Blooming Cereus; Cactus Grandiflorus (Lin.).

PREPARATIONS—

Extractum Cacti Fluidum, Fluid Extract of Cactus. Dose, from one to twenty minims.

Tinctura Cacti, Tincture of Cactus. Dose, from five to thirty minims.

Specific Medicine Cactus Grandiflorus is prepared from the green stem of the true species. The dose is from one-third of a minim to five minims. This is a reliable preparation. Although the medicinal effects may be obtained from two minims, larger doses may be given, no toxic effects having been observed.

The dose of cactus, usually prescribed in the past, has been small, generally not to exceed five minims. A foreign writer has made some observations in aortic lesions, with faulty compensation. He believes that cactus is distinctly specific for these lesions, but he advises it in much larger doses. He gives half a dram if necessary three times a day. The patients treated in this manner had great dyspnea, arrhythmia, with edema of the extremities and ascites. He demonstrated the recession of the cardiac dilatation in these cases.

Physiological Action—This remedy increases the musculo-motor energy of the heart, elevates arterial tension, increasing the height and force of the pulse wave. This is accomplished by increased heart action, stimulation of the vasomotor center, and stimulation of the spinal-motor centers, increasing their activity and improving the general nerve tone. It is the heart tonic par excellence, as it produces stimulation from actually increased nerve tone, through improved nutrition of the entire nervous and muscular structure of the heart. It produces no irritation of the heart muscles like strophanthus, or gastric irritation or cumulation like digitalis.

Cactus exercises a direct influence over the sympathetic nervous system, regulating its action, restoring, normal action, whatever the perversion. It acts directly upon the cardiac plexus, regulating the functual activity of the heart.

Investigations have proven that it increases the contractile power and energy of the heart muscle, through the intercardiac ganglia and accelerator nerves. It certainly improves the nutrition of the heart, as we have noticed the entire removal of progressive valvular murmurs after its continued use.

Specific Symptomatology—An irregular pulse, feebleness of the heart's action, dyspnea, weight, oppression in the chest, violence of the heart's action, depending upon atonicity or enervation, and a sensation of a constriction or band around the heart or around the chest, are the direct indications for its use in heart troubles.

Therapy—This agent is prescribed where the heart muscle is enfeebled, where there is progressive valvular inefficiency, with irregular or intermittent pulse. It is valuable in mitral or aortic regurgitation from whatever cause.

It is an exceedingly useful agent in functional irregularity of the heart, however evidenced, if due to gastric irritation, as the agent in doses of from one to three minims, soothes gastric irritability and imparts tone and improved function, in wide contrast to digitalis, which irritates the stomach.

The action of cactus with nux vomica and hydrastis in the treatment of functional palpitation, depending upon an atonic condition of the stomach, must be emphasized. If extreme acidity be present, they may be combined with an alkaline agent or with neutralizing cordial (glyconda). A number of our physicians recognize this influence, and my own experience confirms its value.

Those who have used all the heart remedies unite in the belief that for breadth of action, for specific directness, for reliability and smoothness and general trustworthiness, cactus takes preference over all the rest. Its influence is admirable where indicated and it is invaluable in many cases. Other remedies in some cases will do as much in single lines, but none will do more, and none will exercise all of its desirable influences.

The writer has given it in valvular troubles, in weak and irregular conditions, depending upon muscular enervation, and in aortic regurgitation, and has seen cures accomplished that had been thought impossible. It permanently strengthens the muscular action of the heart.

The author's experience with this remedy caused him to come to the conclusion a few years ago that cactus had a special sedative influence where indicated. He was convinced of the fact ultimately and now finds excellent authority for his conclusion. Rubini, of Naples, claims that it is almost the counterpart of aconite in its action, differing in that it increases the strength and tone of the nerve centers instead of paralyzing them, as large doses of the latter agent does. Given a condition in which there is a rapid and feeble pulse, weak heart, weak and exhausted nervous system, cactus in small doses, frequently repeated, is a true sedative.

Cactus as a powerful nerve tonic can be relied upon when there is any irregularity of the heart, demanding such a remedy in conjunction with general nervous weakness. It is especially indicated where there is mental depression with despondency and forebodings. It is combined with avena, nux or cimicifuga as I have often suggested with superb results. The above named combination will act as a tonic in a surpassing number of cases of nervous weakness without regard to the specific indications. It improves the nutrition of the brain by improving the circulation in that organ. In this it is of advantage in some cases of neurasthenia, especially in those in which there is a sensation of a band or cord around the body or chest or head, a symptom often spoken of in nervous exhaustion, and in forms of paralysis. Where feebleness is the cause of nervous excitement, cactus exercises a nerve sedative influence. In oppressive headache in the top of the head, causing nervousness, common to ladies at the menopause, resulting from irritation in the pelvic organs, or congestion, or menorrhagia with excessive losses of blood, it is of benefit.

Where there is increased arterial tension, and exaltation of nerve force and excess of strength in the cardiac action, cactus is contraindicated. This is true in prescribing it for heart disease and palpitation. We have had several cases of palpitation, depending on exaltation of nerve energy, increased by cactus, and decreased by gelsemium, cimicifuga or the bromides.

It may be given with excellent results combined with avena sativa in impotence accompanied with general nervous exhaustion, or in combination with avena sativa and saw palmetto in the feebleness and impotency of approaching age, or in the prostration following habits of dissipation, when it will accomplish most excellent results.

It is given in endocarditis and in pericarditis following exhausting diseases as sequelae, With the most gratifying results.

In a marked case of endocarditis following measles, with purple and bloated countenance, distressing dyspnea, and a pulse so rapid, feeble and fluttering that it could not be counted, the dyspnea was overcome, the heart beats reduced to 120, and regular, and every condition improved in the most satisfactory manner in twenty-four hours, incredible as it may seem, by the use of one drop of the fluid extract of cactus every hour.

It is useful in valvular incompetency due to muscular weakness, in the feeble heart action following pneumonia, typhoid and other severe and prostrating diseases. In the feeble heart of exopthalmic goitre, it will do all that is expected of strophanthus.

Dr. Lydia Ross, of Massachusetts, in the Eclectic Review, reports extensively concerning the action of cactus in the disorders of women. She claims it to be specific in that form of oppressive headache, occurring upon the top of the head, not uncommon at the menopause, resulting also from uterine malposition, or congestion.

It is especially valuable in the hot flashes which are so disagreeable during the climacteric. Small doses of the remedy are advisable at that time, and their influence is often a surprise in controlling this otherwise intractable condition. Helleborus niger is an excellent remedy for this condition and they may sometimes be given in conjunction or in alternation. The melancholia, nervousness, irritability of temper, hypersensitiveness, neuralgia, vague fears and fancies, present during the menopause, are all influenced favorably by cactus. Its direct influence in strengthening the nervous system, and in toning the heart and circulatory organs, underlies its influence upon these conditions.

Other conditions common to women, relieved by this remedy, are cerebral congestion, with weight and pain in the occiput, or in the vertex, numbness of the limbs, cough at the supra sternal notch, pain behind the sternum, fear of death, general plethora and congestion. Irregularities of the menses, consisting of a flow too early, too dark and thick, too abundant-a flow which ceases upon lying down, with an inability to lie upon the left side, demand its use.

In cardiac weakness of a less chronic or more acute character than those conditions affecting the aorta, the agent will be found serviceable, as in the threatened heart failure, due to violent over-exercise, as the bicycle heart, a condition not as common as it was when this work was written. It is of great value, as we have previously stated, in the tobacco heart of the cigarette fiend or inveterate smoker. Here it is especially useful. We know of no remedy that will take its place. In the treatment of heart weakness, common to masturbators, and in the feeble heart of the aged, where there are no great organic changes, the remedy is especially advised.

The specific point present in nearly all of these cases indicating the remedy is a vise-like band around the organ affected. It may be the chest, or the stomach, or the heart, bladder, uterus or vagina, or it may be around the body. There is likely in the severe cases to be suffocation, faintness, cold perspiration and great fear of impending danger. If with the above symptoms, there be epistaxis, hematemesis, or hemorrhage from any organ or part, the agent is demanded.

Dr. Lyman Watkins confirms most of the statements made by Dr. Lydia Ross in its use in hysterical conditions, and as a remedy to relieve the functional disturbances which the heart exhibits, from menstrual disorders. He believes it to be a most valuable remedy in the rapid and feeble heartbeat of anemia and chlorosis, greatly facilitating the influence of other indicated remedies. He reports a case of a gentleman of thirty who was suffering from cardiac irregularity of a mild type, accompanied with a persistent and almost excruciating pain in the deep muscles of the back, over the region of the kidneys. Morphine and opium had been given persistently, for this severe pain. Cactus given for the heart symptoms relieved the pain permanently, in a very short time.

Dr. Coffin, of Indianapolis, uses this remedy to overcome subnormal temperature. He believes that it will prove a satisfactory remedy. I have used it in a few cases with good results, but unless given in large doses it will have to be given in conjunction with strychnine, nux vomica, or ignatia.

Dr. Felter reported in the Gleaner in 1907 a case of Raynaud's disease where six drops of specific cactus was given as a nerve sedative with curative results on the real disorder. He was greatly impressed by the action of the agent. It may be combined with cimicifuga or gelsemium for nervousness, with pulsatilla for hysteria, and may be given with an alkaline remedy in very feeble old ladies who suffer from vertigo and general heart feebleness.

One doctor reports an increase of temperature from ten drops of cactus three times a day. Where there is a nervous hyperesthesia with excitable heart action cactus will aggravate the symptoms, I believe, whatever they may be.

Cactus in the treatment of heart trouble where there is epilepsy as previously referred to, was fully enlarged on by a writer in the Eclectic Medical Journal for April, 1912. While the remedy is not always used alone in the treatment of epilepsy, it was cured. The doctor believes it to be a very important auxiliary.

Cactus has been advised in the treatment of car sickness and in sea sickness. It might be combined with advantage with gelsemium or the bromides. it has also been given in the treatment of morphine habit, but the case reported by Dr. Cox took cactin tablets. Its action in this line should be observed.

Dr. Carey, of Ohio, gives cactus with strophanthus in combination in cases where the circulation from heart fault is very imperfect, three or four drops of each.

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.