Preparation: Fluid Extract of Convallaria
"The rhizome and rootlets of Convallaria majalis, Linné"—(U. S. P.).
COMMON NAMES: Lily of the valley (Lilium convallium), May lily.
Botanical Source.—This plant is a low, glabrous, stemless, perennial herb, with a much-branched, slender, creeping, whitish rhizome, sending up from a bud 2, sometimes 3 oblong or ovate-elliptic leaves, the petioles of which are long and sheathing, and rolled together so as to appear stalklike. The flowers are borne on an angular scape, in the form of a raceme, and are handsome, fragrant, nodding, bell-shaped, and waxy-white in color. The perianth has a recurved lobes, and is deciduous; the stamens, 6 in number, are inserted at the perianth-base. The style is stout and single, and the stigma triangular. The fruit is a few-seeded, red berry.
History and Description.—This beautiful wild flower is indigenous to Siberia, and to a large part of Europe, from the Mediterranean northward, and is found in the mountainous woods of our own country from Virginia to the Carolinas and Georgia. It blooms in May and June. The cultivated flower is somewhat larger than that of the wild species, and is a general favorite on account of its beauty and fragrance. All parts of the plant are possessed of medicinal properties, the rhizome alone being official. It is described as follows: "Of horizontal growth and somewhat branched, about 3 Mm. (1/8 inch) thick, cylindrical, wrinkled, whitish, marked with few circular sears; at the annulate joint with about 8 or 10 long, thin roots; fracture somewhat fibrous, white; odor peculiar, pleasant; taste sweetish, bitter, and somewhat acrid"—(U. S. P.). The flowers have a bitter, acrid taste, and the root is best when gathered in August.
Chemical Composition.—The flowers of this plant contain a crystalline, odorous body, isolated in 1835 by Herberger. So powerful is its odor that headache is said to be induced by it. When much diluted it is extremely fragrant. Two glucosids were found in the root and herb by G. F. Walz in 1858 (Amer. Jour. Pharm., 1859, p. 557). The first is convallamarin (C23H44O12). It occurs as a very bitter, subsequently sweetish, amorphous or imperfectly crystalline powder, insoluble in ether, but soluble in amyl alcohol and chloroform, alcohol, wood alcohol and water. Heated with diluted acids it splits into convallamaretin and sugar. The second glucosid is convallarin (C34H62O11), the acrid principle, occurring in rectangular, prismatic crystals, which, although but little soluble in water, impart to the solution an acrid taste, and cause it when agitated to foam as if saponin were present. Alcohol readily dissolves it, while ether does not. Heating with diluted acids causes it to split into convallaretin and sugar. (See Buchner's Rep., 1835, p. 397, and Husemann and Hilger, 1884.)
Action, Medical Uses, and Dosage.—In its effects upon the human circulatory system, convallaria very closely resembles digitalis, without, however, causing the unpleasant disturbances produced by the latter. Besides its effects upon the heart it acts upon the gastro-intestinal tract, producing emesis or purgation. The entire plant should be used to get the best effects, the flowers alone having been found quite inert. It seems well established that the failures attributed to this drug have been largely due to the poor preparations used, for it is certainly true that representative preparations have a pronounced action upon the economy. Convallamarin is decidedly toxic, death having promptly occurred from suspension of the heart action when introduced directly into the veins of the rabbit. The powdered flowers are sternutatory, and have been used in fomentations for the removal of ecchymosed spots caused by bruises. Epilepsy, worms, and miasmatic fevers have been treated with the root. The chief use of convallaria, however, is that of a heart remedy. Owing to its controlling action upon the heart it acts secondarily as a diuretic and was first employed in dropsy for this purpose by the Russians. Like digitalis, it is useful in those cases of dropsy where the cardiac debility is such that there is imperfect circulation through the organ itself, and where there is evidence of obstruction. Palpitation and irregular movements, dyspnoea, diminished renal action with increase of solids in the urine, hepatic fullness and engorgement, and oedema, are usually symptoms of this form of cardiac inefficiency. The cases of dropsy benefited, therefore, are those of cardiac origin with feeble circulation and diminished blood pressure. In small doses convallaria is a tonic to the heart, strengthening its action. Cardiac excitation is relieved by moderate doses, while large doses increase the heart action. Medium-sized doses are recommended in the early stage of carditis (Webster). Mitral insufficiency, with the attendant dyspnoea and palpitation, is considered as a proper condition for the exhibition of convallaria. When the favorable action upon the heart and vessels begins the heart-beats become slower, normal rhythm is established, heart power is increased, arterial pressure is augmented, respiration deepened, and the suffocative sensation, with the distressing and painful desire for air, is dispelled. Convallaria should be thought of in the cardiac debility following severe and exhaustive diseases, such as typhoid fever, la grippe, etc. It tends to promote a normal circulation, and relieves that sense of praecordial faintness which is apt to follow prostrating conditions. Convallaria has had no bad effects upon the cerebro-spinal tract, nor upon the digestive organs. In fact it is rather a tonic to the latter, increasing the appetite and digestive power, and acting slightly as an aperient.
Compared with digitalis, convallaria is generally as efficient, both as a heart tonic and as a diuretic, and in many cases is said to act better. It is safer than digitalis, which may destroy life by paralyzing the heart, an effect never produced by convallaria. Moreover, it is freer from cumulative effects. Vomiting, anorexia, disordered digestion, cerebral excitation, and pupillary dilatation, in addition to its acrid taste, make digitalis often an unpleasant remedy. Convallaria is free from these objections, and may be substituted whenever the former has to be withdrawn.
It should be borne in mind that the heart irregularities benefited by this drug are not those due to organic degeneration so much as those of an obstructive character, due to mechanical causes, and particularly where the mitral valves are involved. Insufficiency or stenotic conditions of the aorta are less benefited than mitral complications. While it may be said that convallaria is never contraindicated in proper doses, it is, however, more particularly designed, according to Prof. Scudder, "to lessen the frequency of the pulse when there is an impaired capillary circulation, as shown by ecchymosis, or by the slow return of blood when it is effaced by the finger" (Spec. Med.). Rheumatism, when associated with disordered circulation has been relieved by it. The aqueous extract of the whole plant in doses of from 15 to 20 grains a day, is said to be an efficient form of administration (Germain-Seè); the dose of the infusion of the whole plant (ℨi to water fl℥iv) is 1/2 fluid ounce; of the fluid extract, 5 to 15 drops; the tincture, 5 to 30 drops; specific convallaria, 2 to 10 drops 4 times a day; convallamarin, from 1/80 to 1 grain.
Specific Indications and Uses.—Heart irregularities due to mechanical impediments; mitral insufficiency; dropsy of cardiac origin; palpitation and vehement heart action, with arrhythmical movements, dyspnoea, and diminished arterial pressure. Quickened pulse with capillary obstruction.
Related Species.—Polygonatum biflorum (Walter), Elliott. Convallaria biflora, Walter. Hairy Salomon's seal, Smaller Solomon's seal. Formerly the species named as growing in the United States, and as being used medicinally, was indicated as Convallaria multiflora of Linné, or Polygonatum multiflorum of Desfontaines. The only species of Polygonatum, however, growing in the United States in the territory ascribed to the preceding, are the Polygonatum biflorum, Elliott, and the Polygonatum commutatum (R. & S.) Dietrich. The former is from 8 inches to 3 feet high, and has the under surface of the leaves pubescent. It thrives in woods, on high banks, hillsides, mountains, and in thickets, from New Brunswick to Ontario and Michigan, southward to Florida and West Virginia, and westward to Kansas and Texas. It blooms from April to August.
Polygonatum commutatum (R. & S.), Dietrich (Polygonatum giganteum, Dietrich; Convallaria commutata [R. & S.]); Smooth Solomon's seal, Great Solomon's seal, Giant Solomon's seal.—A glabrous species seldom found in dry situations, but thriving in moist woods and along streams from Rhode Island to Ontario and Manitoba, southward to Georgia and Louisiana, and westward to Utah, New Mexico, and the Rocky Mountains. It blooms from May to August, and is quite variable both in size and in the form of its leaves.
Vagnera racemosa, Morong; Convallaria racemosa, Linné, Smilacina racemosa, Desfontaines); False Solomon's seal, Spiked Solomon's seal, False spikenard.—Common in copses in the United States. Rhizome thick, sweet, with a stem from 1 to 2 feet high, downy, and recurved at the top. Leaves from 4 to 6 inches long, about one-third as broad, oval, acuminate, veined, minutely pubescent, on petioles not exceeding 2 lines in length, often sessile. The flowers are very numerous, small, white, on white pedicels, with white, exserted, tapering filaments, constituting a large, compound, terminal raceme. Berry 3-celled, pale-red, speckled with purple, aromatic (W.—G.).
The rhizomae of the foregoing plants are inodorous, but of a mucilaginous, somewhat sweetish taste, followed by a faint sense of bitterness.
The name Solomon's seal is derived from the peculiar seal-like scars left upon the rhizome by the decay of the stems of the previous year's growth. The True Soloman's seal is derived from the Polygonatum multiflorum, Allioni (Convallaria multiflora, Linné, and Polygonatum officinale, Allioni (Convallaria Polygonatum, Linné). Indigenous to Europe, northern Asia, and Afghanistan. Their rhizomae and plants yielded (Walz) pectin, sugar, starch, mucilage, asparagin, and convallarin.
Although used with asserted benefit in several diseases by many physicians, yet the American species of these plants have received but little attention as to their true therapeutical characteristics. They are reputed tonic, mucilaginous, and mildly astringent, exerting a specific influence upon irritated and relaxed mucous membranes. Of much value in leucorrhoea, menorrhagia, female debility, and pectoral affections. In piles, the root chewed and swallowed, or a decoction drank as freely as the stomach will bear, will give prompt relief, or the root may be applied to the part with a similar result. An infusion of the root will be of great efficacy in irritable conditions of the intestines, as well as in chronic inflammations of these parts, especially when attended with burning sensations, pain, etc. In erysipelas and cutaneous affections of an erysipelatous nature, as well as those maladies of the skin produced by the poison-vine, or resulting from the poisonous exhalations of other plants, the decoction of Solomon's seal root will afford direct relief, and an ultimate cure. It may also be applied externally, with advantage, to local inflammations. A large dose of the decoction will often provoke emesis or nausea, and act as a cathartic. Dose of the decoction, from 1 to 4 ounces, 3 times daily. Solomon's seal 4 ounces, water 2 pints, molasses 1 pint, simmered down to 1 pint, then strained and evaporated to the consistence of a thick fluid extract, and 1 ounce or 1/2 ounce of powdered resin mixed with it, in doses of 1 teaspoonful several times a day, forms an excellent remedy for piles. The rhizomae of the various species maybe used collectively under the term Solomon's seal.
Zygadenus venenosus, Watson. Nat. Ord.—Liliaceae. Northwestern states. The poisonous bulb of this species, according to Watson, is known to the northern Indians of this country, as Death camass. Violent spasms have been observed by Dr. S. H. Goodell from the ingestion of the plant. Several members of this genus are accredited with poisonous qualities.
King's American Dispensatory, 1898, was written by Harvey Wickes Felter, M.D., and John Uri Lloyd, Phr. M., Ph. D.