SPHERE OF ACTION
The great centre of action for Belladonna is upon the cerebro-spinal nervous system, especially affecting the cerebrum, producing active congestion of the whole encephalic mass, delirium, mania, insomnia, sopor, exhaustion,a nd active inflammation of the brain, with flushed face and violent throbbing of the carotid arteries.
The medulla oblongata, and the nerves that arise from it, are powerfully irritated by the Belladonna poison, as shown by their perverted function, such as difficult deglutition and articulation; spasms of the larynx and pharynx, spasmodic cough, stridulous respiration, &c. Post-mortem examination discloses considerable cerebral congestion, involving also the cerebellum and medulla oblongata.
Upon the Eyes it produces anaesthesia, amaurosis, visual hallucinations, photophobia, and through the sympathetic, it produces dilatation of the pupil, with brilliant, staring eyes, and conjunctival inflammation.
Upon the Throat it produces excessive dryness; the mucous membrane is of a deep crimson color; with constant inclination to swallow, and the secretions are entirely arrested.
The sphincter muscles of the bladder, rectum and uterus, are completely paralyzed by the Belladonna poison.
Upon the Spinal Cord and its membranes, Brown Sequard says,The two remedies most powerful in diminishing congestion of the spinal cord, are Belladonna and Ergot of Rye. These two remedies are powerful excitants of unstriped muscular fibres in the blood-vessels, in the uterus, in the bowels, in the iris, &- c. Both of them dilate the pupil; both are employed with success to produce contractions of the uterus; but each of them has more power in certain parts than the other. Belladonna acts more than Ergot on the blood-vessels of iris (which is the principal cause of dilatation of the pupils) on the blood-vessels of the breast, (which is the principal cause of the cessation of the secretion of milk,) on the muscular fibres of the bowels (which is the mode of its action in strangulated hernia;) on the sphincter of the bladder (which is one of the causes of its success against nocturnal incontinence of urine).
Ergot acts more than Belladonna on the muscular fibres of the uterus, and on the blood-vessels of the spinal cord.
Upon the Skin it has a remarkable and powerful effect; the skin becomes intensely red; painful and hot; parts much swollen, identical with phlegmonous erysipelas. The inflammation is more obstinate and deep seated than that which calls for Aconite.
Upon the Generative Organs it produces congestion and spasm.
Marcy and Hunt say : The specific action of Belladonna is on the cerebral system, which is the central point from which all its symptoms radiate, as from a centre in all diseases. Even the inflammations induced by this remedy always emanate from within outwards, by an increased action in the central organ. Thus in the exanthemata, as soon as the eruption appears, the severe cerebral symptoms, the headaches and general febrile symptoms (caused by the nervous system irritating the vascular), disappear. When an exanthematous eruption is suppressed, the brain is instantly the seat of violent attack. Belladonna cures only those disease of the splanchnic nervous system, or of the abdomen or uterus, in which there are more or less brain symptoms. In all visceral inflammations cured by Belladonna, we may safely conclude that these diseases were expulsions of inimical agents, which originally threatened to attack the cerebral nervous system. The same remarks apply to all fevers, especially typhus, or the febris nervosa versatilis.
Belladonna is then the specific remedy for the disease of the nervous system. especially for the fifth pair, and vascular system under the influence of this sphere. An inflammation or fever to which it is applicable, is accompanied by symptoms peculiar to the fifth pair,- more or less reddened conjunctiva, the white of the eye is injected an unsteady or fixed look, distorted features, turgescence of the face, confusion of the head, aching pain in the forehead and eyes.
Speaking of inflammation, Prof. R.Ludlam says: Belladonna is centric in its operation. It diminishes the calibre of the blood- vessels, after having just impressed the cerebro-spinal centres.
The capillary contraction, occasioned by its primary action, is followed by a relaxation in the fibrous coat of the vessels, which corresponds to Bennett’s second stage of inflammation. This change from contraction to dilatation is more or less marked in degree, and depends upon a diminution in the reflex power of the spinal cord, which Brown-Sequard says Belladonna and Ergot may occasion. It is due to a disorder in the motor current at its source. The hyperaemia results from a direct derangement in the function of the vasomotor nerves. In all essential particulars, so far as the local tissue is concerned, the consequences do not differ from those produced by Aconite. But in their mode of action, they are diametrically opposed.
And this is the indication to their proper therapeutical employment in the treatment of congestions. Aconite is preferable to Belladonna in the congestive stage of most cases of pleurisy and pericarditis, because the engorgement is due to causes acting concentrically; the lesion is idiopathic. The animal nervous centres are not primarily implicated as they are by Belladonna.
Belladonna reduces the hyperaesthesia of the nervous system, upon which the congestion is consequent. It affords relief by a removal of the cause of the abnormal phenomena. It does not promote diaphoresis, is not critical in its results, has no special relation to the emunctories, but is appropriate to, and exercises a calmative influence over the deranged function of reflex action.
In treating of the action of Belladonna in scarlet fever, P.P. Wells, M.D., says: The pain, intolerance of light, vertigo, insensibility, sleep, convulsions, &c., which characterise the action of Belladonna on the cerebral apparatus, find their counterpart in the symptoms of acute inflammation, for the most part of the membrane of the brain, or, it may be of its substance, though this is more rare. In the case before us, the brain is not suffering, as is often thoughtlessly supposed, from inflammation, but from toxication. Not from excessive, but from deficient action. In all its CHARACTERISTICS, it discloses a state as nearly the opposite of that produced by the action of Belladonna as can well imagined. The drowsiness and coma of Belladonna are accompanied by,
if not the result of, active cerebral congestion, and the same is true of the convulsions it produces. Paralysis from the action of Belladonna, is the result of pressure on the brain, either the accumulation of a continuously increasing congestion of this organ, or of its membranes, or of accumulated serum in its ventricles and between its membranes, in the effusion of which a previous congestion has terminated. Paralysis, in scarlet fever, is only one of the manifestations of that loss of brain-power in general, the sum of which is at once expressed by the them `Paralysis of the Brain.’ The loss of power in distant parts is the result of loss of power in the brain itself.
Mind.- The primary perception or starting point of the affection is in the brain.
Furious delirium, with a wild look; wishes to strike, bite or quarrel; face flushed and eyes red.
Almost constant moaning, the child remains in a drowsy, sleepy state, with starting and jumping while sleeping; flushed face and red eyes.
Child cries out suddenly, and ceases just as suddenly.
Desire to escape, with restlessness and anxiety.
Rage, tears the clothes, bites, kicks, strikes, howls, and shrieks.
Crying, laughing, dancing, or muttering delirium, with phantasms.
Sleepiness, but cannot sleep.
Head.-Violent congestion of blood to the head, with loss of consciousness; carotids throb violently; jugulars swollen; face bloated and red.
Throbbing headache, with violent congestion of blood to the head, and throbbing of the carotids; worse from motion and touch; light and noise are intolerable.
When stooping, or rising from a stooping posture, has vertigo, with flickering before the eyes, and a tendency to fall backwards, or to the left side.
Vertigo, with vanishing of sight, stupefaction and debility.
Epilepsy from irritation of the medulla oblongata.
Infantile convulsions, when of an active character, and starting from the medulla oblongata.
Neuralgia in the right side of the head and face.
Eyes.-Eyes red, glistening and sparkling; wild and unsteady look.
Congestion of blood to the eyes, with bright redness of the vessels. Contracted pupils.
Paralysis of the circular fibres of the iris, and optic nerve.
Distortion, spasms, and convulsions of the eyes.
Things look red; sees sparks of fire.
Neuralgia, particularly affecting the right eye.
Face.-Face very red and congested, or great paleness of the face.
Spasmodic distortion of the mouth.
Face swollen, bright red, erysipelatous.
Thick swollen upper lip; gums swollen.
Digestive Organs.-Great dryness of the fauces; tonsils bright red and swollen.
Tongue partially paralysed; right side most affected.
Sore throat; fauces and pharynx deep red, soft palate and tonsils swollen; swallowing painful, particularly of fluids; speech thick; feels as if there was a lump in the throat, which induces hawking; the throat is swollen outside, and sensitive to the touch.
Parotid glands hard, red, and swollen.
Spasms of the throat, cannot swallow.
Inflammation of the inner mouth, with redness, and the mucous membrane swollen.
Tongue hot, dry, red, cracked; or red on the edges, with brown fur in the centre.
Toothache of a drawing, throbbing, tearing nature; worse at night; from cold air; mental exertion, and from contact.
Spasms of the stomach during a meal, the pain running through to the spine.
Colic in hypogastric region, as if from clutching and griping with the nails.
Tenderness of the abdomen, is aggravated by the least jar even of the bed or chair upon which she lies or sits. She is obliged when walking to step with great care for fear of a jar.
Involuntary discharge of the faeces, from paralysis of the sphincter ani.
Piles, with a feeling as if the back would break.
Piles so sensitive to the slightest touch that the patient has to lie down, with the nates separated.-RAUE.
Involuntary discharge of urine, form paralysis of the sphincter vesicae.
Generative Organs of Women.-Great pressing in the genital organs, as if every thing would protrude.
Pressure as though all the contents of the abdomen would issue through the genital organs, this is particularly felt early in the morning.
Os uteri rigid, hot and dry.
Vagina hot and dry.
Menses too early; blood bright red.
Profuse flooding, with a feeling as if everything would issue from the vagina.
Spasmodic contraction of the uterus.
Inflammation of the uterus.
Acute metritis, with many brain symptoms.
Breasts feel heavy, are very hard and redness runs in radii.
(Streaks from a centre).
Men.-Inflammation of the testicles, with great hardness.
Chest.-Constriction of the trachea.
Takes cold from every draft of air, especially when uncovering the head; complaints from cutting the hair.
For common colds, with hard, dry, teasing, spasmodic cough, it is the best remedy we have, especially if it is worse at night.
Skin.-Erysipelas, with smooth shining skin, and not much swollen.-RAUE.
Eruptions, smooth and scarlet color, with very pale face.
Glands inflamed, swollen and indurated.
Inflammations that come suddenly, and leave suddenly.
All fevers traceable to an invasion o the functional powers of the brain itself.
Disease are usually worse after 3 p.m., and again after midnight.
Where there s a doubt whether Aconite or Belladonna should be given, I have always found that a disposition to perspire constitutes a valuable indication for Belladonna.-BAEHR.