BOTANY AND MEDICINE 449 



become even more useful. There is evidence that single purified Veratrum 

 alkaloids do not possess the efficiency of alkaloid mixtures of the crude 

 drugs. Furthermore, some patients develop a decrease in sensitivity to all 

 forms of Veratrum after a few weeks of medication. 



Rauwolfia and its alkaloids are much slower in their onset of activity than 

 Veratrum and khellin. On the other hand, as a hypotensive agent Rauwolfia 

 reduces arterial blood pressure and slows the heart rate somewhat in the 

 same manner as Veratrum by inhibiting centrally mediated cardiovascular 

 reflexes. Rauwolfia is efficiently absorbed by the oral route, but it possesses 

 a significantly long latent period before activity can be observed. This phe- 

 nomenon has not been clearly explained. Incidences of toxic effects have 

 been much less than those from Veratrum medication, but nevertheless some 

 side effects such as nausea, headache, dizziness, and diarrhea have been 

 reported following Rauwolfia alkaloid medication. Sensitivity to the actions 

 of this drug has not yet been significant. 



One of the outstanding attributes of Rauwolfia and its alkaloids has been 

 its tranquillizing action on the higher centers of the central nervous system. 

 This sedation effect is unlike that of the barbiturates and other hypnotics. 

 It has widespread application in the treatment of schizophrenia and other 

 forms of mental disease, particularly such as cause deep mental depression. 

 In fact, the use of this drug in neural psychopathic conditions has almost 

 superseded its use as an antihypertensive agent. Rauwolfia medication has 

 practically replaced frontal-lobotomy operations in many mental hospitals 

 in the United States. Its effect in this respect has indeed created significant 

 social problems as far as long-term mental patients are concerned. One must 

 realize, however, that it still is early to predict the true lasting virtues of the 

 drug when so employed in our mental hospitals. 



A sidelight on the development of both Rauwolfia and Veratrum drugs has 

 been a need for the proper identification of these plant and crude drug mate- 

 rials. More than ten species of Rauwolfia yield known alkaloids, but only two 

 or three possess alkaloids of medicinal value. It was soon found that diffi- 

 culties in isolating active constituents and in obtaining consistent results with 

 extracts of both drugs were due to the prevalence in commerce of several differ- 

 ent species, many of which later were found to be lacking in the desired prin- 

 ciples. This situation led to the need for establishing careful means for identify- 

 ing raw materials and resulted in many useful discoveries, as far as the cellular 

 elements of both drugs are concerned, by which different species can be 

 detected in every form before being processed chemically. 



Khellin, the component of Ammi visnaga, has not proven to be the efficient 

 h)T3otensive agent that was originally attributed to it. It does, however, possess 

 a more direct antispasmodic effect on the smooth musculature, including the 

 blood vessels, than does Veratrum or Rauwolfia. It enhances coronary blood 

 flow and in this aspect has a persistent effect; but rather insignificant effects 



