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---Constituents---A poisonous alkaloid, named Spigeline; also a bitter acrid principle, soluble in water or alcohol, but insoluble in ether; a small amount of volatile oil, a tasteless resin, tannin, wax, fat, mucilage, albumen, myricin, a viscid, saccharine substance, lignin, salts of sodium, potassium and calcium. The reactions of the poisonous alkaloid resemble those of nicotine, lobeline and coniine.
---Medicinal Action and Uses---Its chief use is as a very active and certain vermifuge, most potent for tapeworm and specially so for the round worm; its use was known among the Indians for worms long before America was discovered. It is a safe and efficient drug to give to children, if administered in proper doses and always followed by a saline aperient, such as magnesium sulphate, otherwise unpleasant and serious symptoms may occur, such as disturbed vision, dizziness, muscular spasms, twitching eyelids, increased action of the heart. In large doses, these are increased, both circulation and respiration being depressed and loss of muscular power caused, and cases have been known resulting, in children, in death from convulsions. It is also useful for children's fevers not caused by the irritation of vermin, such as those occurring from hydrocephalus.
---Dosage---The official U.S.P. preparation is the Fluid Extract: average dose, 1 fluid drachm.
It is also given in infusion and in powder.
It is often combined with a cathartic - Senna, Fennel and Manna - the narcotic illeffects being thereby avoided.
Dose of powdered root for an adult: 1 to 2 drachms, morning and evening, for several successive days, followed by an active purgative. For children, 10 to 20 grains.
The infusion is made of 1/2 OZ. troy of the bruised root to 1 pint boiling water. Dose for children, 1 tablespoonful, night and morning; for adults, a teacupful.
There is a preparation much in use called Worm Tea, composed of Spigelia, Savin, Senna and Manna, in the proportion of amounts to suit the individual need.
---Adulterations---Spigelia is frequently adulterated, so that an absolutely genuine and pure article is said to be the exception. The rhizomes are often extensively adulterated with those of Ruellia ciliosa (Acanthaceae); they are, however, longer, straighter and thicker and the rootlets less wiry.
The rhizomes of species of Alpine Phlox, Phlox ovata, P. Carolina and P. glaberrima, are used in some localities and sometimes offered entirely as Spigelia. Those of P. glaberrima are somewhat darker and less ridged than Ruellia and more closely resemble Spigelia. Those of P. Carolina are rather coarse and straight, brownish-yellow, with a straw-coloured wood underneath and a readily removable bark.
The rhizomes of Golden Seal and Caulophyllum have often been found intermixed with the genuine Spigelia.
In cases of poisoning, the stomach should be emptied and stimulants administered, the patient being kept warm in bed. Artificial respiration with oxygen must be immediately resorted to if there are signs of respiratory failure. As an antidote, give strong tea or 15 to 20 grains of tannic acid in aqueous solution.
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