Botanic Remedies 175 



aconite or veratrum. Blood-pressure is not influ- 

 enced and the only definite effect is a paralysis of 

 the inhibitory mechanism of the heart. 



THERAPEUTICS. Gelsemium is not a safe remedy 

 in large dosage. As such doses are necessary to 

 secure its mydriatic action, any definite influence 

 upon severe convulsive disorders, or to accomplish 

 much as a circulatory depressant, the drug should 

 never be used in place of the agents of the bella- 

 donna group, either to produce mydriasis or the 

 antispasmodic effects of this group; it should not 

 be used in the treatment of tetanus, chorea, etc., 

 and it should not be used in the place of aconite in 

 the treatment of cardiac and cardio-vascular con- 

 ditions, or in the treatment of fever in general, 

 though it is a valuable auxiliary in the management 

 of some febrile conditions. 



The true role of gelsemium may be said to be 

 wholly directed to the nervous system, 1st, in certain 

 neuralgic conditions; 2d, in cerebral hyperemia, espe- 

 cially with irritated centers; and 3d, as a terminal anti- 

 spasmodic. These indications are arrived at partly 

 from the pharmacology and partly from clinical 

 experience. They depend upon the initial and not 

 upon the toxic properties of the drug, and they are 

 met by comparatively small dosage. Even here, 

 the drug is contraindicated when, as has been well 

 said by Felter, "the eyes are dull, the pupils dilated, 

 and the circulation feeble. Under these circum- 

 stances it is poisonous even in small doses." 



Trigeminal neuralgia, especially of its facial 

 branches, responds unusually well to gelsemium. 

 Nervous headache, often really neuralgic or from 

 eye-strain, responds in many cases. True intercostal 



