338 VEGETABLE DRUGS 



prolonged and systole is strengthened but unaltered in time. Arterial 

 tension is raised and the pulse wave is increased in volume and force. 

 The physiological details are not so well ascertained as are those of dig- 

 italis, but it is known that strophanthus directly stimulates the heart 

 muscle in moderate doses. The vessels are slightly contracted, but not 

 as much so as by digitalis. Increased blood pressure results mainly 

 from the augmented heart's action. In poisoning, the peripheral vagi 

 are paralyzed and vascular tension falls, owing probably to tetanic con- 

 traction of the ventricles. The heart is arrested in systole or diastole. 



Nervous System. — Muscles and Respiration. — Strophanthus is a pow- 

 erful muscle poison. Therapeutic doses increase muscular activity and 

 tone, while toxic quantities paralyze voluntary muscles. Medicinal doses 

 not only stimulate the voluntary muscles, but also the unstriped muscle of 

 the heart, and to some extent that of the vessel walls. The nerve centres 

 and trunks are unaffected except by the local application of strophanthus, 

 which paralyzes the sensory nerve endings and muscular tissue. The 

 respiration is uninfluenced by therapeutic doses of strophanthus, but in 

 poisoning death sometimes takes place from respiratory failure following 

 paralysis of the respiratory muscles. 



Kidneys. — The kidneys are irritated by large doses of strophanthus 

 and the urine is albuminous. Inflammation of the renal tubules with 

 minute hemorrhages are found post mortem. The renal vessels are not 

 dilated, and the oncometer shows that the size of the kidney is not in- 

 creased. Strophanthus has not so much diuretic action as digitalis. The 

 active principle is eliminated in the urine. A cumulative action in the 

 lower animals and in man has been noted by several observers. 



Uses Internal. — In general, it may be stated that the indications for 

 strophanthus are identical with those for digitalis, but the former is not 

 so certain in its effects. It is of value as a substitute for digitalis when 

 this medicine is not effective, as sometimes occurs when it hinders the 

 transmission of impulses over the bundle of His. Strophanthin has been 

 used with remarkable success as a heart stimulant given once daily intra- 

 venously or intramuscularly, well diluted with water, as it is too irritating 

 subcutaneously. Strophanthus is indicated in mitral disease, cardiac 

 dropsy, pericardial effusions, pulmonary edema, and chronic nephritis; 

 but in heart disease digitalis should be tried first. 



SciLLA. Squill. (U. S. & B. P.) 

 Synonym.— SqaiWs, E.; meerzwiebel, G.; scille, squille, Fr.; bulbus scillse. 



The fleshy, inner scales of the bulb of Urginea maritima (Linnfi) Baker 

 (Fam. Liliacese), cut into pieces and carefully dried. 



Habitat. — Southern Europe, on the shores of the Mediterranean. 



Description. — In irregular, more or less curved, somewhat flattened pieces; 

 from 0.5 to 5 cm. in length, yellowish-white, somewhat translucent, nearly smooth 

 and lustrous; odor slight; taste bitter and acrid. The minimum lethal dose (as 

 tincture) not more than 0.006 mil for each gram body weight of frog. 



Constituents. — Various active principles have been recovered, but it is doubt- 

 ful if any completely represent the action of the drug. All possess some poison- 

 ous properties. Merck sells three substances derived from squill: (1) Scillitoxin, 



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