THE
MEDICAL EXAMINER,
AND
RECORD OF MEDICAL SCIENCE.
NEW SERIES.—NO. LXXL—NOVEMBER, 18 50.
ORIGINAL COMMUNICATIONS.
Observations on the Emmenagogue properties of Poly gala Senega.
By Caspar Morris, M. D., of Philadelphia.
Among the articles contributed to the materia medica by our
own country, not one is more important than the Polygala senega.
However little its virtues may be esteemed abroad, there are few
American physicians who do not recognise its importance in the
treatment of certain stages of croup and bronchitis. My present
object, however, is not. to celebrate its praises in affections in
which its value is so generally appreciated, but to draw attention
to its effects in a class of cases which often baffle the efforts of the
physician and cause no little anxiety to the patient;—to properties
■which, though recognised before, have been overlooked or
forgotten. It is now more than twenty years since my attention
was first directed to the emmenagogue properties of this root. I
cannot recal the source from which the knowledge of its virtues
was derived, but am disposed to ascribe it to the teaching of Pro-
fessor Chapman, as I find on reference to his work on therapeutics,
that he speaks of them in very strong terms of commendation, and
gives the credit of first drawing the attention of the profession to
them, to the late Dr. Joseph Hartshorne. At the period to which
I refer, I was induced to direct the employment of the Senega for
an unmarried lady, of about thirty years of age, suffering from sup-
pression of the menstrual discharge of several months duration,
combined with a catarrhal affection. So prompt was the restora-
tion of the uterine discharge, that I considered it a mere coinci-
dence, and remarked it as one of those cases of facts which may be
misapplied so as to teach error instead of truth. Since then I have
had ample opportunity to verify its claims to the credit of the
result.
The tendency of its influence to the sexual and urinary organs
has often since arrested my attention, in cases of children to whom
I have given it for croup, in which I have found difficult micturi-
tion follow its use, sometimes to a degree quite inconvenient.
Pereira mentions among its physiological effects,“ increased se-
cretion of urine and a feeling of heat in the urinary passages,” and
adds, “it appears to excite moderately the vascular system, to pro-
mote the secretions, (at least those of the kidneys and skin, uterus
and bronchial membrane,) and to exert a specific influence over
the nervous system he mentions the fact that “ it has been used
as an emmenagogue in amenorrhoea.” In the Dispensatory of
Wood and Bache there is a mere casual allusion to its having been
recommended in amenorrhea; while Dr. Eberle refuses credence
to the assertion that it possesses any emmenagogue properties.
The strong testimony of Dr. Chapman deserves to be disseminated
anew, as it may be overlooked among the many modern works on
materia medica and pharmacy. I shall therefore furnish it for the
benefit of your readers.
He introduces it first on the list of emmenagogues in the follow-
ing terms:—
“ To Dr. Hartshorne of this city, we owe the credit of having
discovered the properties of this article as an emmenagogue.
Conversing with him some years ago on the difficulty of man-
aging certain forms of amenorrhoea by the common treatment,
he told me that he thought he had used it with advantage in these
cases. Confiding in the accuracy of his observations, I determin-
ed to lose no time in making trial of the medicine. This I have
done since, both in my public and private practice, to a considera-
ble extent, and with sufficient success to warrant me in recom-
mending it as one of the most active, certain, and valuable of the
emmenagogues. It may be used either in powder or decoction,
though I greatly prefer the latter mode. My rule in the administra-
tion of the medicine, is to direct about four ounces of the decoction,
more or less, during the day, according to the circumstances of the
case. But at the time when the menstrual effort is expected to be
made, and till the discharge is actually induced, I increase the dose
as far as the stomach will allow, having given sometimes as much
as two ounces every hour. In the interval of the menstrual periods,
I lay aside the medicine for a week or two, as, without these
intermissions, if it does not lose its power, it becomes disgusting to
the patient.” Dr. Chapman directs the decoction to be made by
putting one ounce of the bruised root in a pint of boiling water, in a
covered vessel, and reducing it one third by slowly simmering; and
recommends that its nauseating tendency should be averted by
the addition of an aromatic bitter. I have not found my patients
able to bear so large doses as those indicated by Dr. C., and have
been wont to add liquorice root, which disguises the peculiar taste
of the senega, and to continue the process until it is reduced to
one-half. A tablespoonful three times daily of this strength, is gener-
ally tolerated without difficulty. My habit is, when I can deter-
mine the period at which the natural tendency to the discharge
will occur, to give the medicine in these doses for a fortnight be-
fore ; and then, as Dr. C. advises, I have suspended it until the
same period is again approaching. The causes of interruption to
the menstrual discharge, being various, it is of course impossible
to find any remedy which will meet every case. Where it de-
pends on debility, or accompanies an anemic state of the system,
other remedies than senega are more appropriate, or should be
conjoined with it. Iron, aloes and myrrh, in combination, form an
excellent remedy in such cases. The senega is appropriate to
those cases where the suppression has been caused by improper
exposure, and to those very frequent instances in which there is
but little disturbance of the general health.
Every practitioner in our large cities, must have had his attention
arrested by the numerous calls for advice on account of obstruction,
on the part of newly arrived immigrants; who complain of
headache, and miserable general feelings, with swelling of their
lower extremities. To what cause we are to ascribe the interrup-
tion of the natural functions, under such circumstances, it is diffi-
cult to say. The same result has been noticed in the cases of
young women coming from the country to Paris. It is not, there-
fore, due to any impression made by the sea atmosphere, but, very
probably, is caused in both cases by a less nutritious diet than has
been customary, and the confinement in a vitiated atmosphere.
In those cases in which hemorrhoids, or an irritable condition of
the lower bowels, prohibit the resort to the formulae into which
aloes so generally enter, the senega may be resorted to with bene-
fit, and also, when there is a diseased state of the ovaries or ute-
rus itself. I have not yet tried it in cases of dysmenorrhoea, with
scanty secretion, but believe it will be found a very admirable
remedy for these cases, which are so distressing to the habitual suf-
ferer, and vexatious to the physician. I shall certainly take an
early opportunity to test its powers, combined with some of the nar-
cotic extracts. Hellebore and hyoscyamus, have been the agents on
which I have heretofore relied, with a good degree of satisfaction;
and the senega appears to me to partake of the same character as
the hellebore, without that tendency to purge, which is often dis-
played by the hellebore when given in full doses. I am aware that
some of our best teachers are disposed to deny , the existence of a
class of remedies having a specific tendency to promote the men-
strual flow, and rely on general treatment for the restoration of this
function when suspended. This is, perhaps, a natural reaction from
the disposition to rely on specific remedies in all cases. Either ex-
treme, is unsound. We may not disregard the state of the general
health, but must adapt our specific means to meet special indica-
tions. Iknow of no reason to doubt the tendency of certain rem-
edies to produce an action on the uterus in its unimpregnated state,
which would not lie with equal force against the action of calomel
on the liver and salivary glands, or ergot on the same organ at
the time of parturition.