"The rhizome and roots of Caulophyllum thalictroides (Linné), Michaux"—(U S. P.). (Leontice thalictroides, Linné).
COMMON NAMES: Blue cohosh, Squaw-root, Pappoose-root.
ILLUSTRATION: Lloyd's Drugs and Med. of N. A., Vol. II.
Botanical Source.—This plant is a smooth, glaucous plant, purple when young, with a high, round stem, from 1 to 3 feet in height, simple from knotted and matted root-stalks, dividing above into 2 parts, 1 of which is a triternate leaf-stalk, the other bears a biternate leaf and a racemose panicle of small, yellowish-green flowers. The leaves are biternate and triternate. The petiole is trifid, supporting 9 leaflets. The leaflets are oval, petiolate, and unequally lobed, the terminal one equally 3-lobed, paler beneath, and from 2 to 3 inches long. The panicle is small, and shorter than the leaves. The pericarps are thin, caducous, dark-blue, and resemble berries on thick stipes. Seeds 1 or 2, erect, globose, about the size of a large pea (W.—G.).
History.—This drug is one of our oldest indigenous Eclectic remedies. The Algonkin name (cohosh) is generally supposed to have been applied to this plant by the natives, but according to the statement of Mr. W. R. Gerard, this is hardly probable, as the native term, "applied by the whites to several plants, smooth in all their parts, means 'it is rough' (with hairs)." Among the Montagnais of Canada the name cohosh is applied to the bristly fruit of Ribes lacustre. (See D. & M. of N. A). Still, there is no doubt that the plant was later known to the American Indians, in common with Cimicifuga racemosa, Actaea alba, and Actaea rubra var. spicata, as cohosh. The true common name of the plant is blue cohosh, though it is known also in various parts of the country as pappoose-root (Smith), squaw-root (Smith), false cohosh (Eaton), and blueberry. Both Pursh (1814) and Barton (1818) call it cohosh, and state that it was known as such among the natives. The plant was introduced into medicine as blue cohosh by Rafinesque, in 1828, though it is but just to say that the Indian uses of the plant were first made known through an irregular publication entitled "Medical Facts," issued in Cincinnati, in 1813, by Peter Smith, an advertising "Indian herb doctor;" and, it is to Smith that Rafinesque refers as an authority on the subject. The first published botanical record of the blue cohosh is by Gronovius (1789), who received the plant from Clayton, a Virginian botanist, and the second by Cadwallader Colden (1743), an American botanist, afterward distinguished as governor of New York State. Its present botanical name (Caulophyllum) was given it in 1803 by the elder Michaux, who believed the genus to differ sufficiently from the European Leontice, with which it had been classed, to entitle it to a generic rank of which only the one species is now known, which is a native of America, and is found also in Japan. The term Caulophyllum is derived from two Greek words—kaulos, stem; and phullon, leaf; hence, stem-leaf, so called because the leaves terminate in such a manner as to give them the appearance of being a mere continuation of the stem. Blue cohosh is widely distributed throughout this country extending from New Brunswick to the southern limits of the Appalachian system of mountains, and westward to the Mississippi valley. Contrary to published statements it is not found in low, moist grounds, swamps and marshes, along sea-coasts and on prairie lands and irrigated islands, but grows in rich, shady woods, and deep loam, in hilly and mountainous districts. It is plentiful along the Alleghany mountains, but it is not found in the adjacent lowlands in the southern states. Caulophyllum is a handsome plant of a peculiar bluish-green color. It blossoms in April and May and matures its fruit in August. A decoction of the roasted ripened seeds is said to resemble coffee. Although caulophyllum was first introduced by Peter Smith as early as 1813 and endorsed by Rafinesque (1828) and the botanics, there was but little call for it, except in domestic medicine for making infusions and decoctions, until 1852, when Prof King, who first became acquainted with the drug in 1836, brought it out in his first edition of the American Dispensatory, giving a description of it and its uses, and introducing some preparations of it. From that time until the present day it has been in increasing demand in Eclectic practice, and has been adopted by the Homoeopaths, though it is still largely ignored by the "regulars." Prof E. M. Hale, M. D., of Chicago, states that caulophyllum was introduced to the Homoeopaths by Prof. B. L. Hill, at one time Professor of Surgery in the Eclectic Medical Institute, of Cincinnati, O., in his lectures on obstetrics and gynecology before the Homoeopathic College, at Cleveland, O. At the same time he introduced to them hydrastis, cimicifuga and other Eclectic drugs. Among the early preparations of this drug were the fluid extract of caulophyllum, compound tincture of caulophyllum, and the compound tincture of mitchella (mother's cordial), all exclusively Eclectic products. Blue cohosh partially yields its virtues to hot water and glycerin, and fully to alcohol. It may be employed in decoction, or the specific caulophyllum, which is reliable and more convenient, may be used. In purchasing, care must betaken that this root is not mixed with other roots, especially those of the Hydrastis canadensis, with which the pressed and wrapped article prepared for sale is apt to be associated. Caulophyllin added to drastic purgatives, as aloes, podophyllin, etc., will entirely prevent or relieve the tormina attending their action.
Description.—"Rhizome of horizontal growth, about 10 Cm. (4 inches) long, and about 6 to 10 Mm. (1/4 to 2/5 inch) thick, bent; on the upper side with broad, concave stem-scars, and short, knotty branches; externally grayish-brown, internally whitish, tough and woody. Roots numerous, matted, about 10 Cm. (4 inches) long, and 1 Mm (1/25 inch) thick, rather tough, nearly inodorous; taste sweetish, slightly bitter and somewhat acrid"—(U. S. P.).
Chemical Composition.—The most detailed chemical analysis to date of caulophyllum was made, in 1864, by Mr. A. E. Ebert. He found it to contain albumin, starch, gum, coloring matters, calcium phosphate and sulphate, salts of iron, potassium and magnesium, phosphoric acid, silica, and 2 resins, one soluble in alcohol and ether, and the other not soluble in ether, and "a substance similar to saponin." The latter substance was, in 1863, identified and called saponin by Prof. F. F. Mayer, who claims also to have obtained a colorless alkaloid. This alkaloid Mr. Ebert failed to find, and inferred that Prof. Mayer's analysis was made with a drug adulterated with hydrastis, or some other alkaloid-yielding plants. He found also that the only substance of interest was the resinous, saponin-like body. Prof. J. U. Lloyd agrees with him in the main as to his analysis and especially with the latter's statement that the "substance similar to saponin" was the characteristic principle of the plant. This amorphous substance found by Mr. Ebert was at first sweetish, and then acrid to the taste, and irritated the nostrils, provoking sneezing. It was soluble in alcohol, both strong and dilute, and in alkaline aqueous fluids. It remained, however, for Prof. Lloyd to obtain this characteristic principle in a pure, crystalline form, for the white amorphous precipitate found by Mr. Ebert contained much foreign matter that was entirely eliminated, in Prof Lloyd's experiments, by repeated crystallization. To this principle, which, by the way, is a glucosid, Prof. Lloyd applied the name leontin—a name derived from the old Greek botanical name Leontice (lion's foot), applied to the genus (caulophyllum) by Linnaeus. This name, leontin, was given to it because the name caulophyllin, which could most appropriately be given it, had been applied already to the resinoid of caulophyllum.
LEONTIN, as obtained by Prof. Lloyd's process, is a glucosid, occurring in pure, snow-white, feathery, or silky crystals, resembling quinine. It is slightly soluble in cold alcohol, very soluble in boiling alcohol, from which it crystallizes upon cooling. It is slightly soluble in anhydrous alcohol, very soluble in boiling anhydrous alcohol, from which it also crystallizes upon cooling, the most perfect crystals being obtained from absolute alcohol. In sulphuric acid, both cold and boiling, its solubility is similar to that in alcohol. In chloroform it is practically insoluble. It is insoluble in water, and upon the addition of water to the alcoholic solution, immediate precipitation is the result. Acids precipitate it and alter its character, while alkaline aqueous solutions dissolve it freely and perfectly. Leontin is tasteless, but owing to the alkalinity of the saliva, it slowly dissolves, producing an acrid after-taste. Alcoholic solutions of it are acrid to the taste, while the alkaline aqueous solution is extremely acrid and irritating to the mouth and fauces, and for this reason should be administered in syrup, or in sweetened water, which somewhat obtunds these sensations. While odorless, the dust is acrid, producing irritation of the nostrils. Leontin, even in dilute solution, forms much froth when shaken. Prof. Lloyd has further shown that while Prof. Mayer did not obtain an alkaloid from caulophyllum, (which be claims to have done and named caulophylline), such an alkaloid does exist, and that he (Lloyd) has separated it as an amorphous, glassy substance, colorless, tasteless, and odorless, freely soluble in alcohol, and quite soluble in water. It does not possess the characteristics of caulophyllum, nor does it have any sensible properties. The name caulophylline applied by Mayer must not be confounded with that of the resinoid, caulophyllin.
Shortly after 1835, when Prof. John King discovered podophyllin, macrotin, hydrastin, etc., he also brought forth the substance now known in commerce as caulophyllin. It was in great demand among Eclectics in times past, and is still sold in considerable quantities. But like nearly all of the so-called concentrations and resinoids of early Eclectic preparation, while they were better agents than preceding pharmacal products, yet at the present time they are too uncertain in composition and medicinal value, to hold a leading place among our more modern therapeutic preparations. The current statement in medical publications that caulophyllin is obtained by precipitation from a strong alcoholic tincture with water is, according to Prof. Lloyd, erroneous, as there is no evidence from manufacturers to support it. As prepared by Lloyd, whose process is given in "Drugs and Medicines of North America," caulophyllin is a powder of a grayish or brown color, and possesses the characteristic taste of the crude drug. The preparation known as Lloyd's Leontin, is a one per cent solution of the white crystalline emmenagogue principle above described,
Action, Medical Uses, and Dosage.—Of caulophyllum, Rafinesque states that "as a powerful emmenagogue it promotes delivery, menstruation, and dropsical discharges," and that "it was employed by the Indians and their imitators for rheumatism, dropsy, colic, sore throat, cramp, hiccough, epilepsy, hysterics, inflammation of the uterus, etc." Prof. King first employed blue cohosh for its beneficial influence on abnormities of the mucous tissues, using it for aphthous stomatitis in decoction, alone or combined with hydrastis. Prof. Scudder believed that this agent exerted its influence through the hypogastric plexus, thus affecting the circulation, nutrition, and functions of the reproductive apparatus.
Blue cohosh is reputed antispasmodic, emmenagogue, and parturifacient, besides being diuretic, diaphoretic, and expectorant. Its use as a parturient originated in the custom of the Indian squaws of employing a decoction of the root for 2 or 3 weeks previous to labor to facilitate child-birth. This became known to the whites through Smith's publication. There is no doubt but that caulophyllum has a decided action upon the gravid uterus. During labor it relieves false pains and coordinates muscular contractions, at the same time increasing their power. Like macrotys, it is a better oxytocic than ergot. Unlike the latter agent it stimulates normal contraction instead of inducing spasmodic uterine action. It is most valuable in those cases where delay is due to debility, fatigue, or lack of uterine nervous energy, and for deficient contractions where the tissues feel full, as if congested. As a partus praeparator, blue cohosh has enjoyed a well-merited reputation. When used by delicate women, or those who experience prolonged and painful labors, for several weeks previous to confinement, it gives tone and vigor to all the parts engaged in the accouchement, facilitating its progress, and relieving much suffering. Prof. Hale testifies that women who have taken caulophyllum previous to confinement, have overrun their time from 10 to 12 days, but all had very easy labors and made good recoveries. It is a good remedy for after-pains, especially when spasmodic in character. Caulophyllin has also been used for this purpose. It is a remedy for hour-glass contraction and for spurious labor-pains. Blue cohosh acts as an antiabortive by relieving the irritation upon which the trouble depends. King states that for this purpose it is fully equal to viburnum.
As a gynecian remedy it has been employed to relieve irritation of the reproductive organs as if dependent on congestion. It controls chronic inflammatory states of these organs and gives tone in cases of debility. In the sexual disorders of the female it is indicated by tenderness and pain in the uterus, in debilitated patients. It has been very successfully used in cases of hysteria to overcome the attack, and to relieve ovarian, or mammary pain, or irritation when accompanying that disorder. Chronic corporeal, or cervical endometritis, metritis, ovaritis, ovaralgia, uterine leucorrhoea, amenorrhoea, and dysmenorrhoea, are conditions in which it has been most successfully employed. It has an established reputation as a remedy for rheumatism of the uterus, with nervous excitement, for uterine cramps attending menstruation, and for menorrhagia, depending on uterine subinvolution.
As an antispasmodic it has been employed in chorea and epilepsy due to diseased states of the sexual organs, but with varying results. It is better suited for spasmodic intestinal affections, as flatulent and spasmodic colic, and cramps. It is not without value in obstinate singultus. Its antispasmodic effects are permanent.
By lessening irritation it has been serviceable in cystitis, urethritis, chronic nephritis, and albuminuria. Spasmodic retention of urine is relieved by it. It is a good remedy for some cases of rheumatism, though not so valuable as macrotys. It effectually overcomes rheumatoid conditions of the uterus and of the stomach—in the latter instance when crampy pains follow the ingestion of food. While valuable in all chronic cases of muscular rheumatism, it is especially adapted to articular rheumatism, particularly when confined to the smaller joints, as of the toes and fingers. It is a remedy for asthenic plethora, and for rheumatic pains accompanying that condition. Associated with testicular support, it favorably influences orchialgia. By its sedative action it is valuable in some cases of insomnia, and has been suggested as a remedy for bronchitis and catarrhal pneumonia. It is also a remedy for gastric nausea and vomiting. Dose of the infusion (root ℥j to aqua Oj), from 1 to 3 ounces, every 3 or 4 hours; of specific caulophyllum, from 3 to 10 drops; of caulophyllin, from 2 to 4 grains.
Lloyd's Leontin (the1 per cent solution of the emmenagogue principle of blue cohosh) has been very successfully employed in amenorrhoea, dysmenorrhoea, and chlorosis. The dose ranges from 5 to 15 drops in syrup or sweetened water.
Specific Indications and Uses.—The specific indications for caulophyllum are uterine pain, with fullness, weight, and pain in the legs; fullness of tissues as if congested; debility (irritability) of the nervous system, with impaired muscular power; spasmodic muscular pains; articular pain; rheumatic pains of asthenic plethora; epigastric and umbilical colicky pains; dull frontal headache; great thirst; as an oxytocic; to relieve false pains and uterine irritability; sexual debility, with excitability; spasmodic uterine contractions; dysmenorrhoea; irregular menstruation; crampy pains in stomach and bowels after eating; pain in toes and fingers not due to tissue changes.
King's American Dispensatory, 1898, was written by Harvey Wickes Felter, M.D., and John Uri Lloyd, Phr. M., Ph. D.