M. Edouard Vandezande on Colchicum in Dropsy.—The prepa-
rations of Colchicum Autumnalc are usually employed solely on account
of their efficacy in rheumatism and gout. Storck, however, who intro-
duced this plant into the materia medica in 1763, recognised it as a power-
ful hydragogue, and employed it as a succedaneum to squills. In spite
of his recommendations, and of the favourable reports given by Plenck,
Quarin, Zacht, Cullen, and others, the employment of Colchicum in
dropsy has not extended, and at last has been almost entirely neglected.
In later times, the attention of some physicians has been fixed afresh on
the power which Storck recognised in colchicum. Among others, Dr.\
Kennedy, in a memoir presented to the Surgical Society of Ireland,
relates that he has, in a large number of dropsical cases, obtained
astonishing results from the employment of the vinous tincture of this
plant. Having also made use of this preparation in some cases of
serous infiltration and accumulation, I have thought it not unprofitable
to give a summary account of the results which I have obtained; first,
because they are of a nature to lead my professional brethren to have
recourse to the hydragogue power of the plant in analogous cases ; and
also, because the effects of Colchicum have not always been so com-
plete or so manifest as in the cases which I have observed, of which I
shall record the principal.
Case i. Jean Bulckaert, a workman, aged 42, of weak constitution,
was seized, three years ago, with intermittent fever in Flanders, where,
as is well known, this disease is endemic. Having been under treat-
ment for several months in the hospital at Dixmude, he recovered ; but,
on his returning home, where he could only procure insufficient food,
the disease was not long in recurring. Instead of then applying for
medical advice, he had recourse to some domestic remedies, which pro-
duced no effect. The patient soon presented all the characters of
paludal cachexia. The lower extremities, and the whole body in suc-
cession, became oederaatous; the abdomen was distended, and the
respiration impeded. It was when in this condition that Bulckaert first
applied to me. After febrifuge tonics and diuretics had been used for
six weeks, the oedema disappeared, and the state of the patient’s health
seemed satisfactory, although there still remained a slight enlargement
of the spleen, of which he neglected to get relieved. Last April, two
years after the first appearance of the fever, I was again sent for by
him. The dropsy had reappeared, but this time it had not been pre-
ceded by an attack of fever: there was excessive serous infiltration of
all parts of the body, and the urine was slightly albuminous. The same
treatment as before was adopted, but without the least success : I then
prescribed the wine of Colchicum in daily doses of six grammes (about
gii), increasing the dose by a gramme daily. The medicine was well
borne by the patient: it was increased to 40 grammes daily; this
quantity was continued for four days, at the end of which time the
patient was free from dropsy. During the latter period of the treatment,
the alvine evacuations were abundant, and the quantity of urine was
considerably increased.
Case ii. A woman, named Messiaen, became dropsical after an attack
of confluent small-pox : the dropsy was preceded, for some days, by
paroxysms of intermittent fever. Neither nitric acid nor heat showed
the presence of albumen in the urine. I treated her with wine of Col-
chicum, in doses of eight grammes, without any other medicine. At
the end of a fortnight, the anasarca had disappeared, and the patient felt
herself completely restored.
Case iii. A poor woman, who had twice been attacked with articular
rheumatism, from which had resulted an organic affection of the heart,
with habitual dyspnoea, observed her lower extremities to become oede-
matous, without any known cause. The extreme misery in which this
woman was, and her dirty habits, gave but little hope of a prompt result
from any treatment whatever. I resolved, however, to give her Col-
chicum, especially as I thought that the rheumatic diathesis was con-
nected with the production of the dropsy. The medicine was not
well borne, in doses of eight grammes. I diminished the dose by one-
half; but, in a few days, I had to discontinue its use entirely, in con-
sequence of the occurrence of vomiting, dry tongue, and intense thirst.
Some time after, when the symptoms of gastric irritation had been
removed, I again employed the Colchicum in smaller doses, but without
any effect. Mild tonics were then prescribed; and, under their use,
the (edema at length disappeared. The woman has still cedema of the
feet.
Case iv. A miller, addicted to the use of alcoholic liquors, had for
some days complained of courbature, loss of appetite, and a remarkable
diminution of urine, when he perceived symptoms of dropsy. I first
saw him on the 15th of last May. The lower extremities, the scrotum,
and the hands, were very (edematous; the face was much puffed up ;
the abdomen was hard and distended ; the respiration was impeded.
On testing the urine with heat and nitric acid, a large quantity of albu-
men was detected. The tongue was furred, the stools unfrequent, and
the pulse somewhat febrile. The patient complained of no pain in any
part of his body. With the object of cleansing the digestive canal, I
prescribed an emeto-cathartic, consisting of a decigramme (1 j grain) of
tartar emetic, 32 grammes of magnesia, and 250 grammes of water, of
which a wineglassful was to be taken every half hour. The patient
had several evacuations from the stomach and intestines, without any
marked effect on the dropsy. On the 18th of May, wine of Colchicum
was ordered in doses of six grammes, and was very easily supported.
The next day, I increased the quantity by two grammes, and continued
it for ten days. As this treatment produced no amelioration of the
symptoms, the patient importuned me to try some other means. The
urine being still albuminous, I had recourse to the internal administra-
tion of nitric acid, as recommended by Professor Forget. This medicine
had the desired effect. In four or five days, there was a remarkable
diminution in the size of the scrotum, while the oedema of the extremi-
ties decreased; the abdomen became softer, and the face less puffy ;
the urine was more abundant and less albuminous. In spite of the
continued use of the medicine, the patient remained in the same condi-
tion for some time ; and it was only after using Bestuchef’s tincture*
for some days, that the oedema and cachexia disappeared, to be succeeded
by rapid convalescence, and soon by recovery,
• Bestuchef’s tincture, otherwise called Klaproth’s tincture, or ethereal tincture
of chloride of iron, is composed of dry perchloride of iron, one part ; Hoff-
mann’s liquor, seven parts.
1 hese observations appear to me to be of a nature to induce my pro-
fessional brethren to have more frequent recourse to the use of wine of
Colchicum, in the treatment of certain dropsical affections. I am per-
suaded, though unable to specify the cases in which its employment is
specially indicated, that this medicine may often be advantageously sub-
stituted for the hydragogues in most common use. At all events, I
would not recommend it in all cases of albuminous nephritis ; for there
are medicines which act more directly on this disease, and which, there-
fore, seem to me to be preferable. \Jdnnales de la Soc. d’Emul. de la
Flandre Occidentale, as quoted in the Rev. Med. Chirurgiccile de Paris
for August 1849.]