Hydrastis.
[Golden seal (Hydrastis) is endangered. Don't use it unless you know it's cultivated, not wildcrafted. --Henriette]
The dried rhizome and roots of Hydrastis canadensis, Linné (Nat. Ord. Ranunculaceae) United States and Canada in rich, shady woods. (Chiefly Ohio, Indiana, Kentucky, and West Virginia.)
Common Names: Golden Seal, Yellow Root, Yellow Puccoon, Orange Root.
Principal Constituents.—Three alkaloids: berberine (yellow); and hydrastine and canadine, both white.
Preparations and Derivatives.—1. Specific Medicine Hydrastis. Dose, 1 to 30 drops.
2. Colorless Hydrastis (Lloyd's). Dose, 1 to 15 drops. Largely employed locally.
3. Hydrastine Muriate (Hydrochlorate of Berberine). A yellow powder. Dose, 1 to 5 grains.
4. Hydrastin (Resinoid), not now used.
5. Hydrastin (Combined Hydrastin). Only substance now sold as hydrastin.
6. Hydrastina, Hydrastine. (Alkaloid, both natural and synthetic.) Permanent white or creamy crystals or powder, almost insoluble in water; soluble in chloroform; less so in alcohol. Dose, 1/12 to ⅓ gr.; average dose, ⅙ grain.
7. Hydrastinae Hydrochloridum, Hydrastine Hydrochloride (Hydrastine Chloride). White or cream-colored powder, odorless, hygroscopic, very soluble in alcohol and water. Dose, 1/12 to ⅓ grain; average dose, ⅙ grain.
8. Hydrastininae Hydrochloridum, Hydrastinine Hydrochloride (Hydrastinine Chloride). Odorless, light-yellow crystals or powder, very soluble in water and alcohol. Dose, ¼ to 1 grain; average dose, ½ grain
9. Liquid Hydrastis (nonalcoholic). Dose, 1 to 20 drops.
Specific Indications.—Catarrhal states of the mucous membranes unaccompanied by acute inflammation (except in acute purulent otitis media); relaxed tissues, with profuse secretion of thick and tenacious yellowish or greenish-yellow muco-pus; relaxation and ulceration of tissues of mouth and throat; imperfect recovery from diarrhea or dysentery, with mucous discharges and relaxation; aphthae, ulceration, or erosion of mucous surfaces; atonic gastric irritability; irritation of mucous surfaces, with feeble circulation; muscular soreness aggravated by pressure;. passive hemorrhages from the pelvic organs; ice water dyspepsia; skin diseases depending upon gastric wrongs which also indicate hydrastis.
Action.—Extensive experiments by pharmacologists show that Hydrastis alkaloids, particularly hydrastine, are actively poisonous to certain animals, producing spinal convulsions followed by paralysis, lowered blood pressure succeeded by a marked rise, and death. Upon man, however, no so-called physiological effects of any moment have been observed. In the ordinary medicinal doses it certainly is not a poison to human beings. No cerebral effects have been observed in either animals or man; and judging from clinical effects it probably increases contraction of special nonstriated muscles, as it controls uterine hemorrhage in women and has an ecbolic effect upon the lower mammals. Schatz explains this by asserting its power upon the unstriped fibers of the arteries and denying its effects upon other tubular muscular structures. It has also been assumed, but not experimentally proved, that it slightly increases hepatic secretion in man.
Therapy.—External. Hydrastis is one of our most efficient topical medicines when applied in disorders of the mucous membranes; and is occasionally of service upon the skin. It is of most importance perhaps in ophthalmic practice, being a thoroughly effective subastringent and soothing agent in acute and subacute catarrhal and follicular conjunctivitis. For this purpose, and indeed for most topical effects, the colorless preparations are preferred. Lloyd's Colorless Hydrastis in particular is to be commended, for it is both non-staining and non-alcoholic and has almost completely replaced the formerly used hydrastin and berberine preparations. The same medicament may be used in superficial corneal ulcer, ciliary blepharitis, and in simple trachoma. While signally useful in these affections of the eye appendages, hydrastis is of no value in intraocular disorders.
Inspissated cerumen may be readily softened by colorless hydrastis, thus facilitating its removal by water. It also controls the irritation of the aural canal when due to the presence of hardened wax. Eczema of the external auditory canal has been cured by it. In both acute and chronic otitis media it may be employed hopefully when there is a purulent or mucopurulent discharge and granulations do not exist.
Hydrastis preparations are among the most successful remedies in catarrhs of the nose and throat. It should be used both locally and internally in catarrhal and follicular pharyngitis, subacute forms of simple catarrhal sore throat following tonsillitis, subacute rhinitis, naso-pharyngeal and retro-pharyngeal catarrh, and in ulcerated naso-pharyngeal passages. It sometimes aids in the cure of syphilitic ulceration of the upper breathing tract. For catarrhal hypertrophy and engorgement of the turbinates it is often effective. The abundant discharge and thickened Schniederian membranes will guide to its selection. Locke advised it for nasal catarrh with thick, tenacious mucus and almost constant frontal headache. When thick gelatinous masses from the pharyngeal vault constantly drop into the throat, causing hacking cough and nausea, hydrastis given internally and as an ingredient of a local wash gives very satisfactory results. In all catarrhal affections of the upper respiratory tract, hydrastis should be administered for a prolonged period to obtain the best results. Hydrastis is valued by some as a topical reducer for chronically enlarged tonsils, but. like most medicines recommended for that purpose it fails far oftener than it succeeds.
Hydrastis is universally admitted to be a most valuable topical agent in gonorrhea. It is best adapted after the first and acute stage has passed, though it is not contraindicated at any time during the course of the infection. The preparation preferred is the colorless, though other hydrastis preparations, particularly berberine and hydrastin salts are useful, but objectionable on account of their staining qualities. Zinc sulphate increases the usefulness of the drug and quicker results can be obtained by instituting the treatment with a single irrigation with some mild silver salt, in order to destroy the gonococci. Care should be had not to use either the silver or zinc compounds too strong or too freely lest stricture be produced. The great advantage of the hydrastis treatment alone is that, while perhaps slower, it never produces and probably prevents stricture. Hydrastis is especially valuable in the late stage of gonorrheal urethritis, popularly known as gleet.
Leucorrhea, both vaginal and uterine, is well treated with washes containing hydrastis, with or without the addition of indicated cleansing and astringent agents. It heals cervical erosion, which is frequently the source of the abnormal secretion. Jeançon valued it locally for this purpose and to remove light papillary vegetations. As there is usually relaxation and debility, some form of hydrastis should be given internally at the same time. Locke praises hydrastis as a wash for ulceration of the bladder due to chronic cystitis.
Hydrastis preparations are effective in skin disorders depending upon gastro-intestinal debility, with imperfect digestion. Here the local use should be accompanied by its internal exhibition. Such disorders as sluggish cutaneous ulcers, acne, eczema of the scrotum, and eczema of the anus and marginal area, and other orifices of the body come under its influence when used in this manner. It is commonly employed locally to give tone to the rectal tissues, being especially useful in prolapse of the rectum and sometimes relieves non-ulcerating hemorrhoids. In fissures of the anus, rectal ulcers, and proctitis it is a very painful application, and unless very carefully used and in small amounts it may provoke the very conditions sought to be relieved by it. Such conditions readily rebel against continuous stimulating and tonic treatment when irritability and sensitiveness are pronounced.
In most conditions, save those of the conjunctiva, hydrastis gives the best topical results when also administered internally.
Internal. Clinically hydrastis is known to stimulate the salivary, gastric, and intestinal secretions, and, to a slight extent, that of bile. It certainly has a most decided action on mucous surfaces, and is one of the most effective of bitter tonics. It sharpens the appetite and promotes digestion. Disorders of a subacute character and atonic states with increased flow of mucus are the types benefited by hydrastis. It is preeminently a mucous membrane remedy, allaying irritation when present, toning relaxation and correcting catarrhal tendencies. It should be considered when subacute and chronic inflammation with free secretion are present. For aphthous stomatitis it is equaled only by coptis and phytolacca; and is then to be used in the less active forms bordering on chronicity. For gastric irritability it is one of our best remedial resources, but should -not be used when the stomach is acutely inflamed. The more the tendency toward chronic debility with oversecretion the more effective is hydrastis. It first relieves the irritation, then restrains the secretions, and finally gives tone to the gastric membranes. Without question it is our best single drug for chronic gastric catarrh, or so-called chronic gastritis. In that form due to alcoholic abuse, in which occurs the morning vomiting of drunkards, with disgust for food and craving for stimulants, hydrastis, with or without capsicum and nux vomica, gives incomparable results. In this aftermath of chronic alcoholism success attends this treatment in just so far as the patient may be prepared to take and assimilate nourishment. Usually the hydrastis is more efficient with capsicum, and the latter may be given in liberal quantities of beef soup or other easily digested food regularly administered. Bartholow, one of the great therapeutic authorities of his time, and one who was largely responsible for the introduction of hydrastis and other Eclectic medicines into the materia medica of the regular school, went so far as to declare that in sufficient doses of the tincture or fluidextract hydrastis is probably the best substitute for alcoholic beverages when it is desired to abandon the use of spirituous stimulants. Small doses of specific medicine hydrastis are indicated in that form of dyspepsia accompanied by the belching of putrescent gases, and followed by weakness or sense of "goneness" at the pit of the stomach. It also relieves an unpleasant distress just below the sternum, amounting almost to an internal itching and causing one to constantly shift or contract the muscles of the epigastric region. This condition is largely due to gastric irritation with distention by gases, and is promptly relieved best by colorless hydrastis, although the specific medicine is effective. When irritability is marked in stomachal debility small doses of the fluid preparations are to be preferred, but when there is but little irritability larger doses may be used, or hydrastin or berberine salts may be given immediately after meals. Specific medicine hydrastis, or Lloyd's colorless hydrastis, both in doses of 10 drops before meals and at bedtime, are the best agents we have employed in ice-water dyspepsia, a peculiarly American complaint due to the immoderate use of iced drinks and ices. For gastric ulcer no treatment should be considered without a fair and generous trial of hydrastis, geranium, and bismuth subnitrate. In the treatment of stomach disorders with hydrastis or its derivatives, the fact must be kept prominently in mind that it is only in conditions of atony, with gastric irritability or subacute inflammatory symptoms, with increased secretion, that the drug is of any benefit. Acutely inflamed tissues, so far as the gastro-intestinal tract is concerned, absolutely prohibit its employment.
Hydrastis, though most effective in gastric disorders, is valuable in certain affections of the accessory digestive organs. It is of unquestioned worth in catarrhal states of the intestines and gall duct, in duodenal catarrh aggravated by neighboring biliary concretions, and in chronic constipation due to debility and imperfect action of the intestinal glands. Its use must be persisted in for a long period. It is a serviceable tonic for enfeeblement of the gastro-enteric tract of infants and children, as well as adults, and offers support in convalescence from severe and depleting intestinal discharges, debilitating stomach and bowel disorders, the prostration occasioned by fevers and other acute affections, and hemorrhage. It is asserted of value in hepatic congestion. It is a question, however, whether it has any marked specific action upon the liver proper, and that benefit, if any, derived from it in hepatic disorders is largely due to its salutary effect upon the duodenum and bile duct and its properties of a general tonic.
Hydrastis controls passive hemorrhage. It is not adapted to copious active hemorrhages, as gastric and post-partum hemorrhages, but in those forms only of renal, uterine, or pulmonary bleeding in which small quantities of blood are passed at a time and are recurrent in form. It is adapted to and is successful in rare cases to restrain bleeding and to reduce the size of uterine fibroids, and similarly in uterine subinvolution. In passive hemorrhages occurring in virgins and during the climacteric it is distinctly useful. Good results have followed its intercurrent use in congestive dysmenorrhea, menorrhagia, and metrorrhagia, chiefly functional in character. It is a comparatively slow-acting drug in most forms of hemorrhage, but its effects are permanent.
Hydrastis, locally to relieve pain and retard growth, has been advised in carcinomata, particularly mammary cancer. While its general alterative and tonic properties and control over circulatory engorgement may make it a desirable general or supporting agent in carcinomatous cachexia, it is folly, in the light of present-day knowledge of this malignant scourge, to hope for any appreciable results from hydrastis, certainly not for a cure.
