PDR for Herbal Medicines

HERBAL MONOGRAPHS AMERICAN HELLEBORE /25

INDICATIONS AND USAGE

Unproven Uses: The drug has been used for rheumatism,

menstrual disorders and liver disorders, but is rarely used

today.

PRECAUTIONS AND ADVERSE REACTIONS

No health hazards or side effects are known in conjunction

with the proper administration of designated therapeutic

dosages.

DOSAGE

No information is available.

LITERATURE

Hegnauer R. Chemotaxonomie der Pflanzen. Bde 1-11,

Birkhauser Verlag Basel, Boston, Berlin 1962-1997.

Kern W, List PH, Horhammer L (Hrsg.), Hagers Handbuch der

Pharmazeutischen Praxis, 4. Aufl., Bde. 1-8, Springer Verlag

Berlin, Heidelberg, New York, 1969.

American Hellebore
Veratrum viride
** DESCRIPTION
Medicinal Parts: The medicinal parts are the dried rhizome
and the roots.
Flower and Fruit: The terminal inflorescence is a panicle
made up of spike-like racemes. The flowers are short-
pedicled and often unisexual. The perigone has 6 tepals and
is almost free. The anther is reniform. The fruit is capsule-
like with numerous seeds and dividing membranes. The
seeds are flattened, light-brown and winged all around. The
embryo is small and set in the tip of the fusiform endosperm.
Leaves, Stem and Root: The species are perennial herbs with
strong leafy stems. The leaves are spiralled, broadly elliptical
to linear-lanceolate, heavily ribbed and drawn together in a
broad sheath. The leaves of Veratrum viride are oval to
linear.
Characteristics: Characteristics of the species Veratrum
viride is very similar to Veratrum album.
Habitat: The herb is indigenous to the swamps and moist
0> ground from Canada to Georgia and westward to Minnesota.

Production: American Hellebore root is the rhizome of

Veratrum viride.

Not to be Confused With: The rhizome from Symplocarpus

foetidus is thicker than that of Veratrum viride and more

porous.

Other Names: Bugbane, Devil's Bite, Earth Gall, Indian

Poke, Itchweed, Tickleweed

ACTIONS AND PHARMACOLOGY

COMPOUNDS

Steroid alkaloids {!%): including among others, some of the

solanidane-type, isorubijervine, rubijervine- C-nor-D-homo-

sterane-type: including among others, protoverine, protover-

atrine A and B. In contrast with Veratrum album, the less

toxic alkaloids of the solanidane-type are here in the

majority.

EFFECTS

The herb reduces blood pressure and slows down the pulse

due to the alkaloid germitrin. When used externally, it is

hyperemic, hyperalgic, and locally anaesthetic. The drug is

extremely toxic.

INDICATIONS AND USAGE

Unproven Uses: The drug is obsolete due to the high risk of

side effects. Historically, American Hellebore was used

internally to treat pneumonia, peritonitis, epilepsy, pain.

asthma, colds, cholera, croup, consumption, dyspepsia, fever.

hypertension, herpes, gout, headache, inflammation, neural-

gia, whooping cough, puerperal fever, scarlet fever, sciatica.

rheumatism, shingles, toothache, scrofulous, tumors, and

typhus. It was used externally for throat infections and

tonsillitis (as a gargle solution), neuralgia, and skin

irritations.

PRECAUTIONS AND ADVERSE REACTIONS

The drug is severely toxic and has numerous severe side

effects, even in therapeutic dosages. It is no longer adminis-

tered in allopathic medicine. The alkaloids are severely

mucous membrane-irritating, and because they inhibit inacti-

vation of the sodium ion channels after resorption, the

alkaloids have a paralyzing effect on numerous excitable

cells, in particular those governing cardiac activity.

OVERDOSAGE

The first symptoms of poisoning are sneezing, lacrimation,

salivation, vomiting, diarrhea, burning sensation in the

mouth and pharyngeal space, and inability to swallow; then,

following resorption: paresthesia, vertigo, possible blindness,

paralysis of the limbs; also mild convulsions, lowering of

cardiac frequency, cardiac arrhythmias and hypotension.

Death occurs either through systolic cardiac arrest or through

asphyxiation. The alkaloids can also be absorbed through

uninjured skin.

Following gastrointestinal emptying (inducement of vomit-

ing, gastric lavage with burgundy-colored potassium per-

manganate solution, sodium sulphate), installation of

activated charcoal and shock prophylaxis (appropriate body

position, quiet, warmth), the therapy for poisoning consists

of treating spasms with diazepam or certain barbiturates

(i.v.), bradycardia with atropine and hypotension wim

peripherally active circulatory medications. Electrolyte sub-