Continued from previous page.
COMMERCIAL HISTORY OF LOBELIA. [This article should properly follow our description of the drug, p. 67.]—Since the day of Thomson, lobelia herb has been an important American drug. Growing abundantly in the Eastern States the first supply came from that section, but collectors in other parts subsequently gave it attention, and in domestic use and otherwise it is now a drug collected over most of the country in which it abounds. The mountainous part of North Carolina furnishes large amounts.
During its early record when Thomsonism made unexpected demands, and collectors were few, the drug occasionally became scarce, or entirely out of market. Thomson was accustomed to warn his followers of this fact and advise them to secure a supply of "No. 1," [See note page 85.] the first opportunity. He states that in 1807 an offer of one thousand dollars per pound would have failed to procure the drug, and that at another season, two dollars an ounce could not purchase it. [Thomson's Guide and Narrative.] However, at present, it is plentiful and the steady demand is easily supplied. [Thomson asserts that an abundant crop one season is followed by failure the next. We have also observed this, but, we find that it is often scarce for a series of seasons, owing to climatic influence probably, and occasionally is unusually plentiful.]
Lobelia seed, however, often becomes exhausted and occasionally out of market. After an unusually dry season it is scarce. Two years ago it could not be collected. This year (1886) the market is glutted. The demand is small, and, few dealers care to procure more than is necessary for use in one year. Besides, the general drug trade consumes but little, the demand being almost exclusively from a limited number of specialists, who as a rule obtain their stocks from the collectors and do not depend upon the dealer in drugs.
The "Herbalists," [In the "Year Book and Transactions of the Society of United Medical Herbalists of Great Britain," 1885. we find 111 members recorded.] of England, now regard lobelia with much favor, as is evidenced by their action in consequence of an endeavor, recently made by the Law and Parliament Committee of the Pharmaceutical Society, to have lobelia placed on the "English Poison Schedule." [English Poison Schedule, see note p. 88.] They state that they use the herb freely, probably some hundreds of pounds yearly.
PHARMACOPOEIAL HISTORY.—The Pharmacopoeia of the Massachusetts Medical Society, 1808,. under the name lobelia, recognized "the root" of Lobelia syphilitica. The first edition of the U. S. Pharmacopoeia, 1820, as lobelia introduced "the herb" of Lobelia inflata, using as a synonym the common name Indian tobacco. This was accepted by the New York, (1830,) and the Philadelphia, .(1830) editions. In 1840 the term Indian tobacco was dropped and has not since been recorded, although lobelia has been officinal in each successive revision.
The fact that the Massachusetts Pharmacopoeia recognized the root of Lobelia syphilitica, doubtless aided in perpetuating the mistake of so many medical writers who have stated that the root and top of Lobelia inflata is employed in medicine.
Every revision of the U. S. Pharmacopoeia has recognized the herb of Lobelia inflata as "lobelia" and in no instance has Lobelia syphilitica been accepted or the root of any species of Lobelia recognized.
PHARMACOPOEIAL PREPARATIONS.—The first (1820) edition of the U. S. Pharmacopoeia gave a process for making tincture of lobelia, two ounces of the herb to sixteen fluid ounces of diluted alcohol. This proportion was continued through each succeeding revision to 1880, at which time the strength was made two parts of lobelia to ten parts of tincture.
Acetum Lobeliae, introduced in 1860, was made two parts of lobelia to diluted acetic acid, enough to produce sixteen fluid ounces, and in 1880 it was changed, one part of lobelia producing ten parts of the finished vinegar.
It will be observed that the strength of the tincture was increased about one-half in 1880, while the strength of the vinegar was decreased nearly forty per cent. We think that they should have been made identical in strength.
In 1880 the fluid extract of lobelia herb was introduced, diluted alcohol being employed in making it after the usual process for fluid extracts.
UNOFFICINAL PHARMACEUTICAL PREPARATIONS.—Scattered throughout medical and pharmaceutical literature we find many formulas for lobelia preparations. These preparations are still in more or less demand, and occasionally in considerable local use. We reproduce them with as little alteration as possible. The uses and doses are as we find them recorded, and in many cases would be considered inordinate at present.
Cataplasma (Poultice) of Lobelia,—Powdered lobelia herb, two ounces; powdered slippery elm, one ounce. Wet with whiskey; apply to rheumatic part.—(Sick Man's Guide, Lukens, p. 115.) This original compound was evidently followed by Prof. King in the following:
Cataplasma of Lobelia.—To equal parts by weight of powdered lobelia and elm bark add a sufficient quantity of weak lye to form a cataplasm. Used for painful swellings, inflammation of the breast, stings of insects, etc.—Am. Disp,
Enema of Lobelia.—Take of compound tincture of lobelia and capsicum, half a fluid drachm; water, half a fluid ounce; mix them together. A relaxant and antispasmodic clyster. Used in convulsions of infants.—Am. Disp.
Aqueous Extract of Lobelia in flat a.—Lobelia seed, powdered, eight ounces; diluted alcohol, four pints; acetic acid, one ounce. Mix the acid and diluted alcohol and percolate the lobelia seed. Then evaporate to a soft extract.—(Prof. W. Procter,) American Journal of Pharmacy, 1842, p. 108.
Fluid Extract of Lobelia, Compound.—Blood root, skunk cabbage root, lobelia herb, of each four ounces. Make a fluid extract in the usual manner. An emetic, expectorant and antispasmodic. Used as a substitute for acetated tincture of blood root. Dose, from 10 to 60 minims.—Am. Disp.
Lotion of Lobelia, Compound.—Bayberry bark, lobelia herb, yellow dock, of each two drachms; vinegar, one pint; macerate for seven days and filter. Used for local applications in cutaneous diseases, such as erysipelas, inflammation, etc.—Am. Disp.
Liniment of Lobelia.—Stew the seeds of Lobelia inflata in animal oil. This is used to relax rigid muscles and contracted limbs by rubbing it in the skin.—Western Medical Reformer, 1837, p. 206.
Liniment of Stillingia, Compound.—Oil of stillingia, one fluid ounce; Oil of cajuput, half a fluid ounce; Oil of lobelia, two fluid drachms; alcohol, two fluid ounces; mix them together. Used in chronic asthma, croup, spasmodic diseases of the throat and lungs. Apply to the parts affected and take a few drops internally on a lump of sugar.— (Am. Disp.) The Lobelia we think is the chief constituent.—L.
Lobelia Seed with Sugar.—Powdered lobelia seed, powdered white sugar, of each four parts; rub well together and add one part of nerve powder; two parts of capsicum, and add the mixture to thirty-two parts of number six.— Thomsonian, Materia Medica, 1841, p. 699.
Syrup of Lobelia—Vinegar of Lobelia, six fluid ounces; sugar, twelve troy ounces. Dissolve by heat, skim, add a little acetic acid, and strain.—Prof. W. Procter, American Journal of Pharmacy, 1842, p. 109.
Oxymel of Lobelia.—Add one part of strained honey to two parts of sour tincture; heat to boiling point, skim and bottle.—Cost's Domestic Medicine, p. 309.
Syrup of Lobelia, Compound.—Lobelia, four parts; blood root, two parts; macerate in thirty-two parts of vinegar for one week; strain with pressure. Pleurisy root, four parts; solomon's seal, two parts; cover with boiling water and keep hot one day, adding water to produce thirty-two parts of infusion. Mix the two liquids, bring to a boil and add forty-eight parts of sugar. Relieves cough; efficient in croup; used in all cases where it is desirable to increase secretion from the air passages. An excellent diaphoretic, used in all cases of cold.—Domestic Medicine, (Scudder,) p. 230.
Syrup, Well's Vegetable.—Onions, sixteen parts; Spikenard, eight parts; Horehound, four pans; Lobelia, two parts; Pleurisy, two parts; Skunk Cabbage, two parts; Water, forty parts. Mix, boil, strain; evaporate to eight parts. Add thirty-two parts of honey; sixteen parts vinegar, and sixteen parts gin. Dose, one tablespoonful—Improved System Botanic Medicine, 1832, p. 386.
Pills of Aloes and Lobelia, Compound.—Extract of boneset, mandrake, ginseng, of each two drachms; aloes, eight drachms; gamboge, castile soap, of each four drachms; capsicum and lobelia seed, of each one drachm; oil of cloves, two minims; make into a pill mass, and divide into four grain pills. Cathartic. Useful in dyspepsia, constipation, jaundice, etc. Dose, from two to four.—Am. Disp.
Pills, Emetic. Extract of peach leaves, poplar or butternut bark, one ounce; capsicum, one teaspoonful; powdered lobelia seed, half an ounce; nerve powder, two teaspoonful, and a few drops of oil of peppermint. Mix and make into pills.—(Thomsonian, Materia Medica, 1841, p. 699.) (Very indefinite.—L.)
Pills of Lobelia.—Lobelia, seeds, capsicum, and scullcap, each, equal amounts. Make two grain pills. Dose, one to two, every two hours. Three to five at bed time, with composition tea. Uses: coughs, hoarseness, croup, asthma, etc,—Botanic Physician, (Elisha Smith).
Powder, Expectorant.—Powdered skunk cabbage root, four ounces; powdered unicorn root, two ounces; powdered lobelia needs, one-half ounce; mix. Dose, half to a teaspoonful.—Improved System Botanic Medicine, 1832, p. 385.
Powder of Lobelia, Compound.—Lobelia, six drachms; blood root, and skunk cabbage, of each, three drachms; ipecac, four drachms; capsicum in powder, one drachm; mix them together. Used in all cases where an emetic is indicated. It vomits easily and promptly without causing cramps or excessive prostration. Dose, half a drachm every fifteen minutes in an infusion of boneset, until two drachms have been taken, or the patient vomits.—Am. Disp.
Third Preparation.—One ounce of powdered lobelia seed; one ounce of capsicum; one tablespoonful of nerve powder; mix; add to half a pint of Number Six, (No. 6). This is Thomson's great remedy, known also as Rheumatism drops and Hot drops.
Antispasmodic Tincture.—Tincture lobelia, tincture capsicum, of each, sixteen fluidounces; tincture nervine, twelve fluid ounces. Dose, from half a teaspoonful to a tablespoonful. Used as an antispasmodic, and in large doses as an emetic.—(Improved System of Botanic Medicine, Howard, 1832, p. 379.) This is the original formula from which Prof. King devised:
Tincture of Lobelia and Capsicum, Compound. (King's Expectorant.)—Lobelia, capsicum and skunk cabbage, of each, two ounces; diluted alcohol, a sufficient quantity to make two pints of tincture by percolation. This tincture is a powerful antispasmodic and relaxant. Used in cramps, spasms, convulsions, tetanus, etc. Dose, half a teaspoonful as the case may require.—Am. Disp.
Tincture Lobelia herb.—Bruise fresh lobelia, press firmly into a jar, cover with alcohol, after a few days strain and press. To each quart add one ounce of essence of sassafras. Used as an emetic, and for external application to wounds, bruises, inflammations, ulcers, eruptions, etc. Dose, one to ten teaspoonfuls.—(Improved System Botanic Medicine, 1832, p. 384.) The original tincture of lobelia. Dose, now heroic.
Tincture Lobelia seeds.—Digest four and one-half ounces of powdered lobelia seed in a pint of alcohol.—Improved System Botanic Medicine, Howard, 1832, p. 379.
Tincture of Lobelia, Compound. (King's Expectorant.)—Lobelia, blood root, skunk cabbage, wild ginger and pleurisy root, each in moderately fine powder one part; water, sixteen parts; alcohol, forty-eight parts; make a tincture in the usual manner. An excellent remedy for children and infants. Used as an expectorant, as a nauseant in coughs, asthma and where expectorants are indicated—Am. Disp.
Tincture of Lobelia, Ethereal.—Lobelia herb, five ounces; spirits of sulphuric ether, two pints. Make a tincture by percolation.—Edinburgh Dispensatory, 1848.
Tincture of Lobelia and Hydrastis.—Hydrastis, lobelia seed, of each, two parts; diluted alcohol, sixteen parts. Make a tincture by percolation. A valuable local application.—Am. Disp.
Tincture of Sanguinaria, Compound.—Blood root, lobelia, skunk cabbage, of each, two parts; distilled vinegar, thirty-two parts; alcohol, two parts. Make two pints of .tincture by percolation. Used as an emetic and expectorant, Dose, twenty to sixty drops.—Am. Disp.
Tincture of Viburnum Opulus, Compound.—Lobelia seed, skunk cabbage, stramonium seed, capsicum, blood root, of each, one part; diluted alcohol, one hundred and twenty-eight parts. Make a tincture by percolation, Stimulant and antispasmodic. Used in asthma, hysterics and nervous diseases. Dose, twenty to sixty drops.—Am. Disp.
Well's Cough Drops.—Tincture lobelia, one ounce; anodyne drops, two ounces; antispasmodic tincture, one ounce. Dose, half to a teaspoonful.—Improved System Botanic Medicine, 1832, p, 382.
Sour (Acid) Tincture of Lobelia.—Made the same as the ordinary tincture, vinegar being used instead of the alcoholic menstruum.—(Kost's Domestic Medicine, p. 309.) This is the original of the officinal Vinegar of Lobelia.
MEDICAL HISTORY.—Several annoying features in connection with the history of this plant are considered by us, and an endeavor is made to study them in chronological order.
The first printed record of the emetic properties is by Rev. Manasseh Cutler, who named it emetic weed. [Account of Indigenous Vegetables.—Am. Acad. Sciences, 1785, p. 484.] *
Schoepf, 1787, [Materia Medica Americana, 1787, p. 128.] next incorrectly ascribed astringent properties to Lobelia inflata and stated that it was used in ophthalmia. He had confused the two species and affixed the properties of Lobelia inflata to Lobelia syphilitica.
Then came Samuel Thomson, 1 who introduced the plant into medicine about 1793 under a peculiar system of practice or theory, 2 in which he used classes 3 of crude drugs in a system of courses, 4 lobelia being the first class and his principal remedy. He met the opposition of most Regular physicians, who bitterly decried the indiscriminate use he made of drugs, and he eventually was arrested (1809) and tried for killing a patient with lobelia. This trial brought lobelia before the public, and from that time to the present, lobelia has been in more or less demand and has come into use by all schools of medicine. Accounts of its uses and accepted medical properties in the different schools have been written for this work by authorities of these schools.
In studying the history of the introduction of lobelia into medicine the following questions have at various times arisen and attracted more or less attention and discussion by our medical writers.
1st. Did the North American Indians use Lobelia inflata?—In our next article on Lobelia syphilitica it will be seen that Sir William Johnson, preceding 1800, bought a cure for syphilis from the Indians, which turned out to be the root of Lobelia syphilitica. It is asserted in most medical works that the American Indians used Lobelia inflata, but this assertion is not supported by the testimony of any writer we can find who was acquainted with the medicines employed by the Indians, and the pioneer travelers of America (Schoepf excepted, see p. 84,) failed to refer to the plant. We, therefore, conclude that these writers have confused the Lobelia syphilitica of Johnson with Lobelia inflata.
Carver, who spent many years of his life among the Indians, and described the plants, trees and medicines of the tribes among whom he traveled. He does not mention it.
Lewis and Clark speak of the use of the vapor bath, but do not mention that Lobelia inflata was used by the Indians of the Upper Missouri. Speaking of syphilis among the Indians they say: [The Expedition in the Sources of the Missouri. Lewis & Clarke, vol ii. pp. 135 and 136.] "When once a patient is seized, the disorder ends with his life only." They state of the Chippewa Indians, (p 136.) that, "their specifics are the root of the lobelia and that of a species of sumach." It is evident that this is not from observation, as the Chippewas. (also known as the Ojibwas,) were not the Western Indians. They embraced many formidable tribes about the great lakes. Into their country Sir William Johnson extended his treaties, and his statement regarding Lobelia syphilitica, is evidently the source of the statements by Lewis and Clark.
The book of the Indians, 1837, [Book of the Indians. Boston. S. G. Drake, 1837, A very interesting and unique publication.—L.] gives no instance of its use by the Indians, or of any other emetic.
The paper on "Indian Medicine." [Indian Medicine. J M Browne, in Indian Miscellany, p. 74 (Edited by W. W. Beach, 1877).] by Browne, does not refer to any substance that can be identical with lobelia.
Major Long, 1819, in his account of the medicines and practice of the Indians of the West, evidently knew nothing of Lobelia inflata.
Professor Nuttall informed Dr. Mattson that in his excursions among the Indians he had never known them to use Lobelia inflata.
The interesting narratives in "Indian Captivities," contain no record of Lobelia inflata, although rich in the experiences of persons, who passed many years among the Indian tribes east of the Mississippi.
Samuel Stearns, M.D., 1772, in his American Herbal, mentions other species of lobelia, but not Lobelia inflata, and he makes no reference to the Indians using an emetic. Dr. Stearns was a native of Massachusetts and traveled among the Indians of that State with intent to study their remedies, and would not have omitted this plant if it had come under his observation. Neither Schoepf, Barton, nor Rafinesque mentions Lobelia inflata as an Indian remedy from personal experience, and none of these authors would have neglected it, if aware of its being in use.
Catlin, [Manners, Customs and Condition of the North American Indians, Catlin, vol. i., p. 186.] in his explicit descriptions of Indian customs omits it.
However, Mattson, 1841, [Mattson's American Vegetable Practice.] states that, "There is abundant traditionary evidence that it was used by the Penobscot Indians long before the time of Dr. Samuel Thomson, its reputed discoverer, but with the exception of that tribe, I have not been able to discover by any researches I have made, that the American aborigines had any knowledge of its properties or virtues." [Thomson believed that the reference to the use of lobelia by the Indians was an intentional mistatement in order to rob him of the discovery, he writes:
"It is said by Thacher, that it was employed by the aborigines, and by those who deal in Indian remedies; and others, who are attempting to rob me of my discovery, affect to believe the same thing; but this is founded altogether upon conjecture, for they cannot produce a single instance of its having been employed as medicine, until I made use of it. The fact is, it was a new article, wholly unknown to the medical faculty, till I introduced it into use; and the best evidence of this is that they are now ignorant of its powers, and all the knowledge they have of it has been obtained from my practice.—Thomson's "New Guide to Health," 1822, p. 52.] J Mattson, however, neglects to give any positive testimony, or refer to any authority.
Dr. G. A. Stockwell, in a very recent article [Popular Science Monthly, "Indian Medicine," G. A. Stockwell, M.D., Sept., 1886. p. 649] omits it, and thus helps to confirm the fact that lobelia was not used by the Indians.
Therefore, from authorities quoted, and numbers of other works searched without avail, we conclude that the evidence is altogether against the reiterated assertion that Lobelia inflata is a drug handed down to us from the American Indians. We cannot find proof of a single instance where it was employed by them. If the Penobscot Indians used the plant, as Dr. Mattson believed, (from tradition) it is possible that the adjacent settlers learned of its properties from them, but we would more rationally accept that the early use of Lobelia inflata in domestic medicine was an accidental discovery of the whites. Those were days of heroic remedies; bleeding, emetics and blisters were the methods of treatment, and it is not to be presumed that so remarkable and common an emetic as lobelia could remain unknown. That Thomson and Cutler learned of its emetic properties by independent personal experience is undeniable we think, Thomson especially insisting that he stumbled upon it.
It is a common belief with some persons that the Indians used the lobelia in connection with their "Sweat Baths" to clear their minds, and remove their ailments, but our endeavors to find the authority for such statements have resulted in failure. The "Medicine Men," it is true, pretended sometimes to vomit bones, by which the future was foretold, but, this if not a deception had no connection with the medical uses of lobelia, and there is no evidence at our command to support the supposition that the whites learned of its properties from the Indians, or that the Indians used it in medicine.
2nd. Did Samuel Thomson discover the Properties of Lobelia independently of others?—Thomson asserts that, [New Guide to Health, p. 16.] sometime in early life (1773) I discovered a plant which had a singular branch and pods. The taste and operation produced were so remarkable that I never forgot it. I afterwards used to induce other boys to chew it, merely for sport to see them vomit. I tried this herb in this way for nearly twenty years without knowing anything of its medical virtues. This plant is what I have called the emetic herb. [Ibid, p. 27. We must not forget that this was written after the trial of Thomson, and then it seems, there was an intense feeling between Thomson and Cutler.]
Thus it seems that Thomson understood the emetic nature of Lobelia inflata before 1793, but he asserts that, "I tried this herb in this way for nearly twenty years without knowing anything of its medical virtues." He further admits this by saying, "It had never occured to me that it was of any value in medicine until about this time (i793) I have since found by twenty year's experience in which time, I have made use of it in every disease I have met with, to great advantage, that it is a discovery of the greatest importance."
Thus Thomson admits that he knew nothing of the use of lobelia in medicine preceding 1793, and the first record we have of his making use of it in asthma is in 1807, to wit: "In the fall of 1807, I introduced lobelia, tinctured in spirit, as a remedy in asthma."
Mattson, 1841, [The American Vegetable Practice, Mattson, vol. i.] states however, that "it was used as a remedy by many people in New England, long before his (Thomson's) time." He recounts as follows: [Mattson and Thomson were at first friends, but afterward were enemies. It seems to us that Mattson makes it a point to show that Thomson was not first to use lobelia.]
"Mr. Phillip Owen, now eighty years old, relates that when a boy he was sent into the field by his mother to collect some lobelia for a child, sick with the quinsy, and that the herb, administered in the usual manner, afforded speedy and entire relief." This would show a use of it at about 1770.
"Mr. William Coburn, who also reached his eightieth year, says that lobelia has been used as a medicine in the state of Maine, both by the people, and the Penobscot Indians, ever since he can remember, which is a period of not less than seventy years." This also carries us back to 1770.
Dr. John A. Hyde, of Freeport, Maine, a very old physician states that, the people in that vicinity were in the habit of using lobelia under the name colic weed, when he first settled in the town, which was about fifty years ago. He says they employed it in various complaints, but particularly in colic, and considered it perfectly safe and harmless." This carries the use back to 1790, and antedates Thomson again.
Dr. E. Harlow, of New Lebanon, Conn., writes under date of May 15, 1835, to a gentleman in Boston: "I commenced the vegetable or botanic practice of medicine about 1796, under the instruction of Dr. Root, of Canaan, Conn., who was esteemed as an able botanic physician. He made use of lobelia under the name Indian tobacco, and taught me the use of it; and from that period to the present, I have continued to employ it in my practice. I may also state that Dr. Forbes, of Lebanon, used it when I was a boy, and from that circumstance it received the name of "Forbes weed." And lastly, "Doctress Charity Shaw Long, of Albany, N. Y., secured a patent for the use of Lobelia inflata, in 1812, which was one year in advance of Thomson's patent."
Thus from evidence that is entitled to credence it seems that lobelia was somewhat known as a domestic medicine, when Thomson was one year old, and there is little doubt that its use in household practice long antedated any positive information that can be found in print at this late day. Nevertheless, Thomson introduced it to medicine, and none will dispute that Samuel Thomson made lobelia a familiar name to hundreds of thousands of Americans; that he made it notorious none can deny. Whether the domestic uses of lobelia (by a few persons) could have served to give Thomson a start with his "Practice" is a question of little moment. He distinctly asserts that such was not the case, and that he discovered and introduced lobelia independently of all others. In our opinion his statement is entitled to credence. He was intensely enthusiastic on the lobelia subject, and when writers on medicine ignored his claims, to give credit to Cutler and Drury, he considered it an act of injustice, and he expresses himself on the subject as follows: "They cannot produce a single instance of its having been employed as a medicine till I made use of it." [Thomson's Mat. Med. and Anat., 13th edition, p. 585.]
This tendency to neglect him, and, as he believed to persecute him for opinions sake, finally induced Thomson to seek Government protection, both for legal and monetary considerations, resulting in "Thomson's Patent."
Is Lobelia a Poison ?—A recent endeavor has been made in England to place lobelia on the "Poison Schedule", ** and in studying the record we find that in several instances legal steps have been taken to punish persons, who, it was claimed had destroyed life by the injudicious use of this drug. The trials of Dr. Thomson [See note p. 84.] and Dr. Frost have attracted the most attention. ***
In reviewing the cases we find few convictions resulted, and, even then the sentences were light. It seems to us that the prosecution failed because as a rule the evidence did not show that lobelia was really a poison. The members of the Regular Medical Profession were usually the aggressors and seemed anxious to convict, but evidently had at that time but little personal acquaintance with the drug. Their statements in court were usually based upon the papers in Thacher's and Cox's Dispensatories, whereas, the Thomsonians would produce abundance of testimony to show that lobelia in immense doses, far beyond the amounts named as poisonous by the prosecution was continually taken without fatal effects, they would bring as witnesses those who had taken the drug, and they evidently impressed the court with the fact that the Thomsonians were more familiar with lobelia, than were the members of the Regular Medical Profession.
There was another factor in this case, that we cannot underestimate. The cry of oppression and persecutions was raised and the sympathies of many people enlisted in behalf of the Thomsonians from this stand. The Thomsonians of that day were not altogether uneducated as some now suppose. Upon the contrary, we find that many highly cultivated persons adopted their methods and bought the "right." Prof. Benj. Watterhouse, (Professor of Theory and Practice of Medicine in Harvard,) was zealous, also Prof. Tully, of Yale, and throughout New England Thomson numbered his followers by thousands, from among the best informed families. Thus it is, that Thomsonism did not meet the popular disfavor that it held with the Medical profession. To sum up we may be pardoned for observing,
We believe that lobelia is not an active poison, but that injudicious use might result fatally, as is true of other moderately energetic remedies. No doubt more fatal effects would result from its use if it were not so violently emetic that the effect of a poisonous dose of the drug is first to expel it from the stomach.
The physiological investigations of Prof. Roberts Bartholow following, show conclusively that the alkaloid lobeline is poisonous and will produce death in animals.
THE ACTIONS AND USES OF HYDROBROMATE OF LOBELINE.—(Written for this publication by Prof. Roberts Bartholow, M. D., LL. D., Professor of Materia Medica, General Therapeutics and Hygiene, in the Jefferson Medical College, of Philadelphia.)—Preliminary.—This research consists, for the most part, of my own experiments and observations. Facts obtained from other sources have been adopted when my own experiences were in harmony with them. The preparations used were furnished me by Prof. J. U. Lloyd, whose name is a sufficient guarantee of their genuineness. They consisted of one per cent., and one-tenth per cent, solutions of the hydrobromate of lobeline. The investigation includes the physiological and clinical actions of this remedy.
General Result of the Action in Cold and Warm-blooded Animals.—Given in sufficient quantity, an increasing failure of muscular power, staggering and incoordination, retching and salivation, are observed in from five to fifteen or twenty minutes after it is administered. First occurring in the hind extremities the evidences of muscular paresis, then extend to the fore members. The frog becomes less and less able to jump and to turn over from a position on the back, and the rabbit yields in the hind legs, reels, and at length can no longer control these members, and the forearms and arms soon after are disabled in the same manner; sensibility and the brain functions remain unimpaired. Before the paralysis has become complete, if the amount given has not been too large, the receptivity and response to peripheral impressions is for a short period somewhat more ready, and this is, more especially true of frogs. The respiratory function is embarrassed in proportion to the general paralyzing action After a period of rather slower respiration it becomes quicker and increasingly shallow and laborious. With the lessening supply of oxygen, carbonic acid narcosis comes on, and death ensues with complete muscular resolution and without convulsions in frogs, and usually with clonic convulsions in rabbits, the failure of respiration being the immediate cause.
Action on Nerve and Muscle.—When the sciatic nerve is isolated, the limb ligatured, and a merely paralyzing dose is administered, the nerve when excited by a faradic current at the earliest period of the action responds feebly, for the muscles of the limb below the ligature contract but slightly When the paralysis is complete at length the strongest excitation of the nerve causes no response in any degree of muscular contraction. When this occurs the muscles are found to be readily excitable on direct electrical stimulation. It follows hence that lobeline destroys the excitability of the motor nerve endings, and does not impair the contractility of muscle.
There is a stage in the action of small doses, however, when the irritability of motor nerve and muscle is actually heightened: when the paralyzing effect is just beginning to manifest itself after the administration of one minim of the one per cent, solution, a slight tap on the skin of the back causes an immediate response in general muscular movement of a tetanic character. From this it must be concluded that when the first impression of lobeline is making, the nervous tissue is irritated by the medicament, but as the action continues and increases, the irritation is succeeded by loss of function. Furthermore, when the effect of lobeline in small quantity is such as to cause general muscular contractions on irritation of the skin (heightened cutaneous reflex) it is obvious that the physiological effect is not limited to the motor-nerve endings, but includes the spinal cord as well. It may be suggested, that the paralyzers, whose action is first felt by the intra-muscular nerve elements really act through the spinal cord and not as is now supposed on the nerve endings only at the beginning.
Sensibility remains unimpaired, certainly, up to the period of the cessation of all muscular contractility, for the corneal and other reflexes are preserved until then. When the action of lobeline has attained its maximum, the paralysis is complete, and there is no response to any form of irritation.
Effects on the Circulation and Respiration —When the fullest effect of lobeline is attained in the frog, if the chest be opened the heart will be found still in action at about 28 per minute, but the contractions are not energetic, although rhythmical. If the medulla be previously divided, the heart will be found at a standstill, its cavities distended. If in action, electrical stimulation increases it; if at rest, a strong faradic current will start the auricle in active movement, and the ventricle in feeble and irregular contractions chiefly of the basic portion.
The most important of the effects of lobeline on the heart, is its action on the vagus. At first, and with a small dose, the vagus is briefly stimulated then depressed in function, but, it is completely paralyzed at the period of maximum effect, and no strength of current will then stop the heart. With a minute dose, the effect first produced is irritation of the vagus, with slowing of the heart, but as the effect deepens, the heart grows more rapid with lessening of the inhibition. It is probable that every first dose given, causes some slowing of the heart's movements, but this effect is so transient and slight that it escapes detection. With the decline in the inhibition there ensues increased action of the heart and lowering of the vascular tension. The body temperature rises some what pari passu with the increased rapidity of the circulation. As the respiratory muscles fail in power, the breathing becomes more and more labored, panting and shallow. The oxygenation of the blood is progressively diminished carbonic acid accumulates, the lips are cyanosed, and stupor is succeeded ultimately by coma. Up to this point the mental processes are not disordered, and the sensibility remains unimpaired
Therapeutical Applications of Lobeline.—To avoid all subjects of controversy, I confine my observations to facts personally ascertained, and give the results of my own therapeutical uses of this remedy.
Having ascertained that lobeline possesses the power to lessen the reflex action of the spinal centres, I have administered it in those maladies characterized by irritability or exaltation of this function. In epilepsy it appears to be a most promising remedy if right conditions exist. It is the less useful, the more decidedly the convulsive seizures approach the epileptiform character, and it is more effective, the nearer the cases are to the true or essential type. The bromides may be quite successful in arresting convulsions due to coarse lesions of the brain, although not acting on the structural changes in any way. Now lobeline does not act favorably in such conditions.
In nocturnal epilepsy, which, as is now well known, does not usually yield to the bromides, and in the cases not arising from an obvious peripheral irritation or accompanied by a defined aura, in the pale-anaemic and lymphathic type of subject, the best results obtainable from this remedy may be expected. As, however, definite conclusions can be formed only after sufficient length of observations the real value of the hydrobromate of lobeline must be ascertained by comparative trials through several years. Now, it can be asserted merely that this remedy promises well.
More definite results can be given from the administration of lobeline in certain neuroses of the respiratory organs, as asthma, whooping-cough, pseudo-angina pectoris, in the spasmodic cough of emphysema, the cough of habit, renal and other reflex asthmas. Somewhat more specific statements can be made as respects its utility in all these cases.
In that form of asthma, which is merely a functional disorder, the best results may be expected from it. The dose at the outset should be about 1-60 grain, and this can be repeated in a half hour when the attack is acute and severe, and afterwards pro re nata. When the attacks are recurring and persistent, the lobeline should be given three times a day from 1-60th to 1-30th grain, in persons having the ordinary susceptibility to its action, and 1-20th grain in those with less. When desirable or circumstances require, it may be combined with morphine, or cocaine, or both. The asthmatic seizures which attend emphysema are often quite promptly relieved by it. When in the course of chronic bronchitis, the mucous membrane furnishes but little secretion and the cough is dry and harrassing, lobeline acts very efficiently. It has also appeared to do great good in cases of pseudo-angina pectoris, with weak action of the heart and embarrassed respiration. By lowering the vascular tension and lessening the work of the heart by relaxing the inhibition, the pulmonary circulation is carried on with greater ease, and hence the distress of breathing subsides. There is here, as I conceive, a most important sphere of usefulness—for this morbid complexus is by no means uncommon, and we have not many agents capable of affording the direct relief given by lobeline.
THE HOMOEOPATHIC USES OF LOBELIA INFLATA.—(Written for this publication by Prof. Edwin M. Hale, M. D., Emeritus Professor Materia Medica and Therapeutics in the Chicago Homoeopathic College).—I consider that the sphere of action of this species lies midway between tobacco and veratrum album, or their active principles, nicotine and veratrine. It acts upon the motor-nervous system and upon the respiratory centre in the medulla.
The nauseous effects of this drug are far more intense then tobacco, and this is the principle reason why it is not used for the same purpose as tobacco. Another reason is that the system does not tolerate the drug, as it does tobacco. I have, however, seen habitues of lobelia, who, from taking it for asthma and dyspepsia, came to tolerate it to a degree which seemed surprising.
Lobelia inflata was first introduced into our school in this country at the same time and in the same manner as the Lobelia syphilitica, (1838). In 1841 it was introduced into homoeopathic practice in Europe by Dr. A. Arac, of Leipsic, in the 15th volume of "Hygiea." Since that time it has been used to a considerable extent in our practice, but although a powerful drug, its curative sphere is limited.
We find it useful principally in asthmatic affections. It is useful in two varieties, namely, the nervous, which arises from paresis of the respiratory centre, and the catarrhal or "humid asthma." In the first, it is strictly homoeopathic, and has been found curative in very minute doses. In the latter, when the mucus rales are loud, and the sense of suffocation is due to a mechanical obstruction by the mucus, and the coincident spasm of the bronchi, larger doses must be used, for this condition is similar to the secondary effects of the drug. I have seen almost magical relief follow doses of ℨi repeated every hour, without nausea or vomiting follow its use.
Permanent cures of asthma of many years, have been made by larger doses. Sometimes these large doses (half an ounce) have not caused vomiting. At other times smaller doses vomit violently, leaving the patient much prostrated, but with disappearance of the asthma. I have cured asthmatic attacks by small doses of veratrum, when lobelia seemed indicated but had failed.
In some cases of asthma, the patient complains of a "dreadful sinking sensation" in the epigastrum with violent distressing efforts at inspiration. This is a clear indication for the use of lobelia, and it will promptly relieve such cases in doses of 1-10 or 1-100 of a drop frequently repeated.
In cough, lobelia is very useful. The cough may be caused by accumulation of mucus in the pharynx or bronchi, or a tickling in the larynx, or it may be "croupy," or attended by dyspnoea. In purely nervous coughs, like whooping cough, or from irritation of the laryngeal nerves, motor and sensory. In spasmodic croup, it is a prompt and excellent specific, and I have found it useful in carpo-pedal spasms, attended by laryngismus.
In some gastric disorders, lobelia does excellent service. In the so-called nervous dyspepsia, when the patient complains that nausea, oppression of the stomach, and dyspnoea follow each meal, when there is constant "faintness" at the stomach, as bad after meals as before eating, lobelia in doses of a drop of the one-tenth dilution before and after eating has a very happy effect.
This "faintness" at the pit of the stomach is an unfailing guide to its use. It is caused by a paresis of the sympathetic nerve; other drugs cause this symptom; ignatia, cimicifuga, digitalis, and veratrum, all cause it by their depressing action on the same system of nerves. The primary effect of lobelia on the heart is to paralyze its motor nerves, like tobacco or aconite, hence it is a prominent remedy in primary cardiac weakness and irritation. The "sinking faintness" at the epigastrum is here the symptom most complained of. Small doses must be used to combat this condition. Some patients will bear doses of one or two drops of the tincture, others are made worse by it, and only find relief from the second or third dilutions.
The secondary or reactionary effects of lobelia, is to cause violent spasmodic palpitations, or symptoms closely resembling angina pectoris. In such cases I have found quick and good results from 5 to 10 drops of the tincture.
Primarily, lobelia paralyzes the various sphincter muscles, and can be used in physiological doses, for spasmodic retention of urine, or faeces, or rigidity of the os and perineum. Its use in labor in facilitating the expulsion of the foetus is as old as the aborigines. It has been adopted by midwives and many physicians. I have seen a rigid and undilatable os rapidly give way after a single dose of 20 drops. It will allay and regulate those violent pains in the loins during labor, which seem to arise from the rigidity of the genital passages. In dysmenorhoea, due to this same cause, small doses give prompt relief. In this respect it resembles gelsemium and belladonna.
In hysteria, lobelia is frequently indicated. The case of spasm of the larynx reported by Dr. Knowles, of Avoca, Iowa, in my "Therapeutics of New Remedies," is an apt example of a manifestion of hysteria, rapidly cured by this remedy. I have controlled the most violent hysterical convulsions by injecting into the rectum a teaspoonful of the tincture.
In gall stone or renal colic, in incarcerated hernia and in spasmodic gastralgia, lobelia often relieves promptly. This may be said to be antipathic, but I do not believe it. The secondary effect of all paralyzants is spasm and convulsions. Lobelia is as homoeopathic to spasm, as to paralysis.
MEDICAL USES OF LOBELIA IN THE ECLECTIC SCHOOL.—(Written for this publication by Prof. John M. Scudder, M. D., Professor of the Practice of Medicine in the Eclectic Medical Institute, Cincinnati).—We use lobelia for its emetic, its relaxant and its stimulant influence. It is a fair example of the common fact that the action of a drug depends upon its dose. Emesis may be called its poisonous action, and stimulation its medicinal action. In poisonous doses the drug would prove fatal to life were it not that it is expelled from the stomach and exhausts itself in the act of emesis.
Without discussing the advantages of thorough emesis, as compared with other treatment, it may be remarked that the indications and contra-indications for emetics are as distinct as for other remedies. If the patient has full tissues, full pulse, full tongue, heavily coated at base, with sense of fullness and oppression in the epigastrium, lobelia will act kindly. Conversely if the tissues are contracted, the pulse small or hard, and the tongue contracted and red, an emetic should not be used.
In the early part of the century lobelia in substance (usually the powdered seed) was given as an emetic. From this use came the extreme prostration, with cold clammy perspiration and enfeebled respiration and circulation, a condition known as the "alarming symptoms." There is no doubt, but that lobelia has occasionally caused death, but this result has been rare as compared with the large number of cases in which the drug has been used.
It was not long before it was determined that an acid preparation of lobelia acted more kindly than the crude article, or indeed any other preparation. The acetous tincture was easily and cheaply prepared by simply macerating the herb and seed with vinegar, and whether as an emetic or a nauseant expectorant its influence was certain and kindly.
The relaxant influence of lobelia was twofold, as it was exerted on the voluntary and involuntary muscles. For the first, it was the result of more or less profound nausea, induced by large doses just short of emesis. This effect was frequently called "antispasmodic," and was that desired in infantile convulsions, puerperal convulsions, hysteria, tetanus and some cases of asthma. This protracted nausea was also thought necessary to the establishment of mucous secretion from bronchial tubes, the so-called expectorant action.
Its action on the involuntary muscular fiber was not dependent upon nausea. Probably its best and most certain action was in cases of difficult labor from rigidity of the os uteri. In this case an alcoholic tincture from the seed was employed, twenty drops being added to two ounces of water, a teaspoonful was given every fifteen minutes until dilatation was accomplished.
With a full and oppressed pulse and a sense of oppression in the chest lobelia is one of our most certain remedies. The small doses (tincture of the seed) not nauseant, gives relief and a better circulation of blood.
In neuralgia of the heart, and in angina pectoris, no remedy that I have used gives such prompt relief. Frequently a single dose of ten or fifteen drops of a tincture of the seed will give almost immediate relief.
Before the use of belladonna to remove congestion of the brain (patient being comatose) nothing was deemed so certain as a lobelia emetic. In the eruptive fevers with tardy appearance or retrocession of the eruption, nothing was so effective in relieving the nervous system and bringing the eruption to the surface as a lobelia emetic properly given.
When remedies are used in combination it is almost impossible to determine the action of a single agent. Thus many compounds containing lobelia have been highly commended, and have done good service, but what part should properly be credited to this agent we cannot say Among these combinations none has acquired a greater reputation than the compound stillingia liniment, composed of oils of lobelia, stillingia and cajuput, with alcohol. [See formulae, p. 82.—L.] This has certainly a wonderful action in croup, and I have satisfied myself by experiment that a principal action is from the oil of lobelia.
PHARMACEUTICAL AND MEDICAL REFERENCES TO LOBELIA.
1785.—Indigenous Vegetables, Cutler, p. 484, from Am. Journal Science and Arts.
1787.—Materia Medica Americana, David Schoepf, Erlangen, (Germany,) p. 128.
1792.—Medical Botany, Woodville, Vol. II.. p. 249. (Lobelia syphilitica).
1793.—Domestic Medicine, William Buchan, Edinburgh, p. 513.
1798.—Collections for a Materia Medica of the United States, B. S. Barton, part first, (3rd edition, 1810) p. 36.
(two more pages of very small text, then:)
We do not consider it necessary to mention all the works that refer to this plant and its compounds. Since 1809 medical publications of every description have continually mentioned the plant, and medical references are innumerable. In oder to arrive at a correct understanding of the subject, we made comparative studies of the record as found in the preceding works, and have found other publications to present no additional facts. We may safely say that the lobelia history can be as intelligently studied in these as by the aid of additional numberless works that mention the plant.
* Manasseh Cutler, LL.D., was born in Killingly, Conn., May 3, 1742. First he engaged in the whaling business, then in merchandise in Edgertown; studied law and was admitted to the bar in 1767; removed to Dedham, studied theology, was licensed in 1770 and ordained minister of Hamilton, September, 1771. He became chaplain, of Col. Francis' regiment, September, 1776, fought In the action in Rhode Island, and for his bravery received a. present of a fine horse. He also studied medicine and other branches of science. He became a member of the American Academy in 1781, contributing a series of scientific papers to its memoirs in 1785; his botanical paper being the first attempt at a scientific description of the plants of New England. In this paper we have the reference to the emetic properties of lobelia, which is the first printed notice of the nature of the plant, but he did not use it in medicine.
With Dr. Beck he prepared the chapter on trees in Belknap's history of New Hampshire, became a member of the Philosophical Society of Philadelphia, 1784; as agent for the Ohio Company he purchased 1,300,000 acres of land northwest of the Ohio river, 1787, and started the first emigrants to that section, who settled at Marietta, Ohio, April 7, 1788. He accompanied them in a sulky, returning to New England in 1790. Gen. Washington appointed him Judge of the Supreme Court of Ohio Territory, 1795, which honor he declined. He was member of Congress from 1800 to 1804.
In the prosecution of Samuel Thomson, 1809, Cutler was called as an expert to identify the remedies Thomson used. It was about this time that he (Cutler) became interested in the use of lobelia as a remedy for asthma, (see Thacher's Dispensatory, 1810,) and there is reason to believe that his attention was drawn to it by Thomson and his followers, as before this Thomson had used the herb in that disease and his followers were numerous throughout all of New England. Cutler died in Hamilton, Mass., July 28, 1823.
** English Poison Schedule. (1868) This is an English law, designed to protect the public against intentional and accidental poisoning. Among the omissions are such energetic bodies as sulphuric, nitric and hydrochloric acids, (the English Journals often give records of death by them). We presume that the commerce of that country would render it useless to attempt to control these substances. Ergot and oil of savin are listed, and it seems that to these should be added oil of cedar, oil of tansy, oil of pennyroyal, and perhaps gossypium bark, if the unborn are to be considered. Oxalic acid is named, but binoxalate of potassium (a common drug here) omitted. These and other features seem to us to indicate that the list should be revised, and certainly twenty years in our country would demand a revision.
In the recent excitement in England over a death after taking lobelia, many writers urged that lobelia be placed on the poison schedule. In our opinion, this could not be consistently accomplished without adding ipecac, turpeths mineral, and perhaps other like substances. Doubtless, English pharmacists generally agree that a careful revision of their poison schedule is desirable, but, we doubt if it will ever be possible to include all moderately energetic drugs that by abuse may produce death, as is perhaps true of lobelia. In our country lobelia is not considered to our knowledge in any list of poisons. Our hillsides are covered with the herb, its properties are well known, and it is never used as a poison by those inclined to produce death, but is freely employed as an emetic by country people.
*** Dr. R. K. Frost, of New York City, was arrested and tried December i 3, 1837, for killing Mr. T. G. French by putting "him into a vapor bath" and administering "poisonous concoctions of lobelia" and "giving deleterious herbs which no reasonable man would administer to a dog." This trial, next to that of Thomson, exhibited the intensity of feeling that existed at that time, and from over the entire country it attracted the attention of persons who were the least interested in medicine. It lasted ten days and the jury returned a verdict of "guilty of man slaughter in the fourth degree," and recommended the accused to the mercy of the court. He was sentenced to three months imprisonment. The history of this trial was issued in pamphlet form (104 pp.) and used by the Thomsonians over the country to show that they were persecuted.
Drugs and Medicines of North America, 1884-1887, was written by John Uri Lloyd and Curtis G. Lloyd.