126 
Physostigma  Venenosum. 
/Am.  Jour.  Pharm. 
t  March  1,1871. 
PHYSOSTIGMA  VENENOSUM  * 
The  Pliysostigyna  venenosum^  or  ordeal  bean  of  Old  Calabar,  has  of 
late  been  used  medicinally.  Its  peculiar  and  powerfully  poisonous 
properties  were  long  ago  made  known  by  Drs.  Christison  and  Balfour^ 
but  we  owe  the  fuller  knowledge  we  now  possess  of  its  powers  to  the- 
elaborate  investigations  of  Dr.  Fraser,  of  Edinburgh,  Dr.  Robertsont 
and  other  observers.  The  active  principles  of  the  bean  quickly  enter 
the  blood  and  gradually  produce  general  paralysis,  which  is  due,  ac- 
cording to  Dr.  Eraser,  to  changes  effected  in  the  spinal  cord.  In  an 
animal  poisoned  by  the  bean  the  reflex  functions  of  the  cord  are  de- 
stroyed— "  It  acts  on  the  spinal  cord  by  destroying  its  power  of  con- 
ducting impressions."  This  results  "  in  muscular  paralysis,  gradually^ 
extending  to  the  respiratory  apparatus,  and  producing  death  by 
asphyxia ;  and,  in  a  rapid  paralysis  of  the  heart,  causing  death  by- 
syncope.  It  also  causes  paralysis  of  muscular  fibre,  striped  and  un^ 
striped."  The  knowledge  obtained  by  these  investigations  led  to  the- 
employment  of  the  bean  as  a  remedy  in  tetanus,  and  a  considerable- 
number  of  cases  have  been  treated  by  it.  Dr.  Fraser  has  a  high) 
opinion  of  its  value,  and  has  reported  twelve  cases  of  tetanus  treated 
by  it,  of  which  nine  recovered.  Many  other  cases  of  its  administra- 
tion in  this  disease  have  been  reported  in  the  various  medical  journals, 
English  and  foreign,  and  in  not  a  few  of  these  instances  the  patients 
have  undoubtedly  recovered ;  but  the  results,  on  the  whole,  have- 
scarcely  supported  Dr.  Fraser's  estimate  of  the  remedial  value  of  the- 
drug,  while  in  some  cases  it  has  been  suspected  of  doing  harm  rather- 
than  good,  and  of  increasing  the  patient's  danger  by  its  paralysing^ 
action. f  It  has  been  observed,  too,  that  in  most  of  the  cases  of  re- 
covery the  disease  lasted  about  a  month,  just  as  in  cases  successfully 
treated  with  atropia,  hydrate  of  chloral,  and  other  remedies.  The 
physostigma  has  been  employed  in  other  maladies.  It  is  indisputabljr; 
a  weapon  of  great  power,  and  must  be  used  with  great  care  and. 
watchfulness  :  at  the  same  time,  in  such  a  disease  as  tetanus,  it  must,, 
as  Dr.  Fraser  has  insisted,  be  employed  early.  The  Pharmacopoeia 
contains  two  preparations,  the  powder  and  an  extract ;  the  first  may 
*  Abstracted  from  a  series  of  papers  on  the  "Progress  of  Therapeutics," 
published  in  the  Medical  Times  and  Gazette. 
t  Mr.  Holthouse's  case,  Clinical  Society's  Transactions,  vol.  ii. ;  and  Medical. 
Times  and  Gazette,  1869. 
