150 



been, with few exceptions, the out- 

 standing agents in the treatment of an- 

 gina and arterial hypertension. How- 

 ever, an intensive rc-invcstigation of 

 one well known plant drug, Veratrum 

 viride or green hellebore and a similar 

 study of two lesser known plant drugs, 

 Ammi visnaga ( Khella ) and Rauwolfia 

 speeies, have resulted in several new 

 and useful pharmaceuticals of the hy- 

 potensive class. Veratrum and Rauwol- 

 fia represent botanical crude drugs 

 which have been employed in folklore, 

 domestic and foreign medicine for cen- 

 turies and for a variety of purposes. 

 The dried roots of Rauwolfia serpen- 

 tina, a small shrub of India, have been 

 used empirically by people of India for 

 a large variety of conditions, such as in 

 the treatment of snake bites, insanity, 

 high blood pressure, and cardiac dis- 

 ease. 



Tlie question naturally raised is 

 what differences do Veratrum, Rau- 

 wolfia and Khellin possess with each 

 other and over other well established 

 vasodilators in the treatment of essen- 

 tial hypertension? Veratrum and its 

 alkaloids cause widespread reflex vaso- 

 dilatation including that of cerebral 

 and renal arteries and its effects are 

 more rapid than the other two botan- 

 ical agents. However, much evidence 

 can be shown that Veratrum alkaloids 

 or crude drugs are not significantly ef- 

 fective by the oral route in the majority 

 of ambulatory hypertensive patients 

 and rather high incidences of toxicity 

 have been reported following its use, 

 i.e., vomiting and hiccoughing. Much 

 better results have been reported from 

 the use of the alkaloids via the paren- 

 teral route. 



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 inhibit- 



LOWER PLANTS, DISEASES, AND MEDICINE 



ing centrally mediated cardiovascular 

 reflexes. Rauwolfia is cflRciently ab- 

 sorbed by the oral route but it possesses 

 a significantly long latent period be- 

 fore activity can be observed. Inci- 

 dences of toxic effects have been much 

 less than those from Veratrum medica- 

 tion but nevertheless some side effects 

 such as nausea, headache, dizziness and 

 diarrhea have been reported following 

 Rauwolfia alkaloid medication. 



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 antihyperten- 

 sive agent. Rauwolfia medication has 

 practically replaced frontal lobotomv 

 operations in many mental hospitals in 

 the United States. Its effect in this re- 

 spect ha5 indeed created significant 

 social problems as far as long term 

 mental patients are concerned. 



Khellin, the component of Ammi 

 visnaga, has not proven to be the effi- 

 cient hypotensive agent that was orig- 

 inally attributed to it. It does, how- 

 ever, possess a more direct anti-spas- 

 modic effect on the smooth muscula- 

 ture including the blood vessels than do 

 Veratrum or Rauwolfia. The action of 

 Khellin as a smooth muscle relaxant 

 has led to its use in bronchial asthma 

 with some success. It is rapidlv and 

 efficiently absorbed and found to be 

 widely distributed in the bodv. Side 

 effects from Khellin medication have 

 been chiefly those of nausea, mental 

 depression, and some insomnia. But its 

 margin of safety has been considered 

 to be rather wide. 



Muscle relaxants and anti-spasmod- 



