Pulsatilla (U. S. P.)—Pulsatilla.
"The herb of Anemone Pulsatilla and Anemone pratensis, Linné, collected soon after flowering. It should be carefully preserved, and not be kept longer than 1 year"—(U. S. P.).
COMMON NAMES: Pasque flower, Passe flower, Wind flower, Meadow anemone.
ILLUSTRATION: Meehan, Native Flowers and Ferns, Vol. I, 49.
Botanical Source.—ANEMONE PRATENSIS (Pulsatilla nigricans, Pulsatilla pratensis, Miller), True or Small meadow anemone. This is a handsome species of this genus of perennial plants, with simple, erect, rounded stems, from 3 to 5 inches high. The leaves are radical, pinnatifid, and downy; the segments many-parted, with linear lobes. The flowers are solitary, terminal, pendulous, deep-purple or violet-brown, having 6 sepals, somewhat narrow, pointed, reflexed at the point, erect and converging at the base. Stalked glands or sterile stamens are found between the fertile stamens and sepals (L.). The proximity of the involucre is such that it has a calyx-like appearance.
ANEMONE PULSATILLA (Pulsatilla vulgaris, Miller).—This plant differs from the preceding by having the involucre more remote from the flower, at least in the mature plant, in being more hairy, and in possessing a scape curved above and more shaggy than that of the preceding plants. Its flower is but half the size and of a deeper color than that of Anemone pratensis.
History.—Pulsatilla or Pasque flower grows in Turkey, in Russia, and in other parts of Europe, as in Germany, France, Denmark, Sweden, and southern England. It also grows in Asia, in open fields, plains, hills, sandy pasture grounds, and open pine woods, exposed to the sun, flowering early in the spring, and, according to some writers, again in the latter part of summer or early in the fall. Owing to its early blooming period, at about Eastertide, it has been named by the French Pasque flower, having reference to the Passover and Paschal ceremonies. The plant has a very slight odor, and an acrid, pungent taste. The leaves are not fully matured at the early flowering period. The whole plant is covered with soft, silky, white hairs, giving to it a lax, shaggy, woolly appearance. All species of Anemone wilt very quickly. An acrid, volatile constituent is emitted when the fresh plant is bruised, sufficiently powerful to produce lachrymation and even vesication. To give its best therapeutic action, the plant should be put into alcohol before being allowed to dry. Alcohol appears to be its best menstruum. The tincture may be prepared by macerating 2 pounds of the fresh plant in 4 pints of strong alcohol, then expressing and filtering. It has a brownish-green color, and an acrid, pungent taste. Even fluid preparations of pulsatilla become altered with age, consequently the physician should frequently renew his stock.
Description.—The U. S. P. thus describes the drug: "Leaves radical, petiolate, silky-villous, twice or thrice deeply 3-parted, or pinnately-cleft, with linear, acute lobes, appearing after the large, purple flowers; inodorous, very acrid"—(U. S. P.).
Chemical Composition.—Pulsatilla, in fresh condition, yields upon distillation with water, a colorless to yellow, acrid oil, from which chloroform abstracts crystallizable, acrid, vesicating anemone camphor. It is an unstable body and readily decomposes into anemonin and isoanemonic acid, especially when in moist condition. (For further details, see Anemone patensvar. Nuttalliana.) The formula (C10H8O4) given to anemonin by Beckurts (1892) was confirmed by Hans Meyer (Jahresb. der Pharm., 1896, p. 509), who believes it to be related to cantharidin (C10H12O4). Pulsatilla also contains iron-greening tannin.
Action, Medical Uses, and Dosage.—Topically applied, the fresh plant of pulsatilla is irritant, and, if kept long in contact with the skin, may produce vesication. When chewed, it produces a benumbing sensation and tingling formication, somewhat like that produced by aconite or prickly ash. Taken internally in overdoses, it acts as a gastric irritant, producing a sense of rawness, burning, pain in stomach, with endeavors to vomit, all accompanied with marked prostration. A case of poisoning with these symptoms is on record in the Medical Gleaner, Vol. IV, p. 173. A sense of constriction and tightness of the chest, with chilliness, marked weakness, and some congestion, has been produced by large doses. Full doses depress the action of the heart, lower arterial tension, and reduce temperature. Sensory and motor paralyses have followed large doses of pulsatilla, while toxic doses may produce mydriasis, stupor, coma, and convulsions. In medicinal doses, pulsatilla increases the power and regulates the action of the heart, and gives a better character to the pulse rate, particularly slowing the irritable, rapid and feeble pulse due to nervous depression. It improves the sympathetic system and cerebral functions, and especially strengthens sympathetic innervation, this action being very marked in troubles of the reproductive organs of male and female.
Pulsatilla forms an important remedy with the Eclectic physicians as well as with the Homoeopaths, who make extensive use of it. According to the late Prof. J. M. Scudder, M. D., who used it largely in his practice, its most important. use is to allay irritation of the nervous system in persons of feeble health, thus giving sleep and rest, preventing unnecessary expenditure of nerve force, and, by this means, facilitating the action of tonics and restoratives. In feeble women, and men who have become nervous from sedentary habits or mental over-exertion, as well as in the nervousness and restlessness of masturbators, or persons addicted to the excessive use of tobacco, he has found it very certain in its action. It is the remedy for nervous women, when there is debility and faulty nutrition of the nerve centers.
Pulsatilla is a remedy of wide applicability, but more particularly for those conditions in which the mind is a prominent factor. A gloomy mentality, a state of nerve depression and unrest, a disposition to brood over real or imagined trouble, a tendency to look on the dark side of life, sadness, mild restlessness, and a state of mental unrest generally denominated in broad terms "nervousness," are factors in the condition of the patient requiring pulsatilla. A pulsatilla patient weeps easily, and the mind is inclined to wander—to be unsettled. The pulse requiring pulsatilla is weak, soft, and open, and the tissues have a tendency to dryness (except when the mucous tissues are discharging a thick, bland material), and, about the orbits the parts appear contracted, sunken, and dark in color. The whole countenance and movements of the body depict sadness, moroseness, despondency, and lack of tone. Hysteria of the mild and weeping form may be a symptom. The whole condition is one of nervous depression, the nutrition of the nerve centers are at fault. With such symptoms, pulsatilla may be confidently prescribed in the conditions and disorders enumerated in this article. Pulsatilla may be given to produce sleep, when there is great exhaustion and opiates are inadmissible. If the insomnia depends upon determination of blood to the brain, pulsatilla will not relieve, but when due to nervous exhaustion it is a remedy to give rest, after which sleep obtains. Where sleep is disturbed by unpleasant dreams, and the patient awakens sad and languid, pulsatilla should be given. Pulsatilla has a large field in troubles incident to the reproductive organs, of both sexes. As an emmenagogue, it serves a useful purpose in amenorrhoea in nervous and anemic subjects, with chilliness a prominent symptom. When menstruation is suppressed, tardy or scanty from taking cold, or from emotional causes, pulsatilla is the remedy. In dysmenorrhoea, not due to mechanical causes, and with the above-named nervous symptoms, no remedy is more effective. Leucorrhoea, with a free, thick, milky, or yellow, bland discharge and pain in the loins, and particularly in scrofulous individuals, calls for pulsatilla. It is a remedy for mild forms of hysteria, where the patient is weak and weeps easily, has fears of impending danger, and passes large quantities of clear, limpid urine, and menstruation is suppressed.
The long-continued use of pulsatilla as an intercurrent remedy, is accredited with curative effects in uterine colic, but it is of no value during an attack. Pulsatilla frequently proves a good remedy in ovaritis and ovaralgia with tensive, tearing pain. Sluggish, ineffectual, and weak labor-pains are sometimes remedied by this drug. It is frequently a remedy for pain, when dependent on or associated with debility, and sometimes when due to acute inflammation. It is a leading remedy in epididymitis and orchitis, whether due to gonorrhoeal infection or to metastasis from mumps. The dark-red, congested, enlarged, and sensitive testicle indicates it. It relieves the pains of orchialgia, and subdues mammary swelling from the metastasis of mumps. Pulsatilla increases sexual power, but lessens morbid sexual excitement. It is especially valuable in relieving urethral irritation and consequent spermatorrhoea and prostatorrhoea. In these troubles it overcomes the nervous apprehensions so frequently a troublesome feature. It also alleviates the nervous irritability accompanying or produced by varicocele. In gonorrhoea, particularly of the chronic type, pulsatilla is of value, when the urethral membrane is swollen. Pulsatilla has been used by some for the relief of hydrocele, but for this affection we possess better remedies. Many unpleasant conditions of the urinary apparatus are relieved by pulsatilla, as frequent but ineffectual attempts at urination, the bladder giving a sensation as if bloated; dribbling of urine from movement, the dysuria of pregnancy, and in involuntary micturition from colds or from nervous debility.
Pulsatilla frequently proves a useful remedy in headache of various types. It relieves the frontal headache from nasal catarrh, nervous headache, particularly when due to gastric disturbances, with greasy taste, menstrual headache, with chilliness and suppressed menses, bilious and gastric headaches, of a dull and heavy character, with greasy taste and nausea, and headaches due to uterine irregularities or to a rheumatic diathesis. These headaches are all of anemic character—the opposite of those relieved by gelsemium. Though ordinarily not a remedy for acute inflammations (contraindicated in gastro-intestinal inflammation), there are some conditions where small doses of pulsatilla are beneficial when the usual symptoms calling for the drug are present. These conditions are acute inflammation of the nose, fauces, larynx, or bronchiae. It is especially effective in the secondary stage of acute nasal catarrh, when the naso-pharynx is affected and there is a sense of rawness and moisture, and an abundant discharge of thick, yellow, bland, inoffensive mucus or muco-pus. Pulsatilla frequently serves a good purpose in asthma superinduced by pregnancy, or by suppressed menses, and it favorably influences whooping-cough in properly selected cases. So-called "stomach cough" is frequently cured by pulsatilla.
Pulsatilla should be remembered as a remedy of much value to control the catarrhal symptoms of the exanthemata; it also controls the irritability frequently accompanying these disorders. In measles, it has done good service in checking the coryza and profuse lachrymation, as well as the dry, tight, painful cough, and when retrocession of the eruption has taken place, it has reversed this unpleasant condition. It relieves the irritable condition in varicella. Pulsatilla is very efficient in real and imaginary cardiac affections. It has proved useful in cardiac hypertrophy and in dilatation of the venous heart. It is especially effective in functional heart disorders with giddiness, imperfect voluntary motion, impaired vision, and with a symptom described as a sense of pressure over the larynx and trachea, with imperfect respiratory movement, and sense of impending danger; the symptoms just preceding are those not unfrequently associated with functional heart disease, dyspepsia, uterine disease, or over-excitation of the sexual system, and are generally very unpleasant and annoying. It often relieves that form of venous congestion which stops short of inflammation, as in threatened ovaritis, orchitis, varicocele, and crural phlebitis. Varicocele and other varicoses are frequently improved by its administration with other indicated remedies. Its chief advantage, outside of some control over the venous structure, is its relief of the nervous complications. It has been used to good advantage for the relief of hemorrhoids.
Constipation in the hysterical female yields to nux vomica and pulsatilla, and the latter has a pleasing action in some forms of indigestion and dyspepsia. These cases are those in which there is a thick, creamy paste upon the tongue and a greasy taste. Such troubles are frequently brought about by indulgence in pastries and fatty food. Pain is not marked, but there is pyrosis and greasy eructations, gastric distension, uneasy gnawing sensations in the stomach, and chilliness may be a pronounced symptom. The patient is nervous, sad, and may have a soft, yellow diarrhoea. For such cases pulsatilla is an excellent remedy. It is also said to relieve alternating constipation and diarrhoea with venous congestion. Pulsatilla is a prompt and decisive agent in earache, brought on by cold, wet, and exposure to winds. There is an absence of fever, the pulse is open and soft, the child sobs, the face is pale, the tissues full and waxen, the pain is intense and frequently paroxysmal and tearing in character—evidently a neuralgic condition, for physical signs of local disturbance are seldom observed. In purulent otitis media, with thick, yellow, bland discharge, and impaired hearing, and tinnitus aurium, pulsatilla is the indicated remedy.
One of the earliest uses of this plant was for the relief of "amaurosis, cataract, and opacity of the cornea," conditions in which the reputed value of pulsatilla is very much overrated. There is a condition, sometimes known as "nervous blindness," which has been benefited by pulsatilla, and this is probably the condition formerly referred to under the elastic term amaurosis. Pulsatilla stands out prominently as a remedy for hordeolum or "stye." It is also a prompt remedy when the conjunctiva is hyperemic and the vision weakened, especially after reading, or from sexual abuse or sexual excesses, and in profuse lachrymation from exposure to winds or when in the wind. It should be used locally (gtt. x to aqua ℥ij) and also given internally in small doses. In chronic conjunctivitis, with bland, yellow discharges, in scrofulous individuals, or due to the exanthemata, and in ophthalmia neonatorum, with like discharge, pulsatilla has been used with signal success. It relieves deep-seated, heavy pain in the globe of the eye, and has been recommended in inflammation of the lachrymal sac. Störck, who was one of the first to use pulsatilla, considered it useful in secondary syphilis, and in some forms of cutaneous diseases, as well as in amaurosis and other ocular affections.
This drug has been used with much success in rheumatism, when the pains were shifting and relieved by cold and aggravated by warmth. Depression of spirits is here a prominent feature. It has also aided in restoring the flow of milk in agalactia in nervous and fear-depressed women, whose breasts were painful and swollen. Prof. W. E. Bloyer emphasizes its value in "jerking" or "jumping" toothache, usually due to the formation of a pus cavity near the nerve. He applied the full strength specific pulsatilla, or diluted one-half with water, besides giving the drug internally. He also recommends this treatment as "especially useful in inflammations caused by dead teeth, and the inflammatory, painful, and unpleasant conditions of the pulp cavity in those in which the nerve has been destroyed" (Ec. Med. Jour., 1895, p. 248). The dose of specific pulsatilla is from a fraction of a drop to 10 drops, administered in water; of the fluid extract, from 1 to 15 drops; of the extract, from 1/6 to 1 grain; of anemonin, 1/20 to 1/4 grain.
Specific Indications and Uses.—Nervousness and despondency, sadness, unnatural fear, tendency to weep, morbid mental excitement, marked depression of spirits; pain, with debility, nervousness, headache, not dependent on determination of blood to the head; insomnia, from nervous exhaustion; neuralgia in anemic, debilitated subjects; pasty, white, or creamy, thick coating upon the tongue, with greasy taste; stomach disorders from indulgence in fats and pastries; thick, bland, inoffensive discharges from mucous surfaces; alternating diarrhoea and constipation, with venous congestion; amenorrhoea and dysmenorrhoea, with gloomy mentality and chilliness; severe pains in the ear, non-inflammatory and evidently neuralgic; pain from exposure to wind; jumping toothache, from abscess near the dental pulp; styes.