Description
Medicinal Parts
The medicinal parts are the rhizome and root.
Flower and Fruit
The flowers are in racemes that form a 30- to 60-cm panicle. The pedicles are much shorter than the flowers. The yellowish-white flowers consist of 6 similar tepals, which are oblong-lanceolate, acute, denticulate, and broadly splayed. There are 6 stamens, which are shorter than the perigone, and 3 styles. The fruit is capsulelike.
Leaves, Stem, and Root
The plant is roughly 60 to 120 cm high. The rhizome is short, cylindrical, and stunted. It has numerous, long, thick and fleshy root fibers. The round, canelike, glabrous stem is almost completely surrounded by the tight sheaths of the basal leaves. The basal leaves are whorled, broad, elliptical to linear-lanceolate, and heavily ribbed.
Habitat
The plant is found from Lapland to Italy but not on the British Isles.
Production
White Hellebore rootstock is the rhizome of Veratrum album.
Actions & Pharmacology
Compounds
Steroid alkaloids (mixture is referred to as veratrine, 0.8-2.5%): C-nor-D-homo-sterane type-including protoverine, protoveratrines A and B, germerine, jervine, protoverine, veratroyl zygadenine
Solidane type-including isorubijervine, rubijervine
Effects
Internally, the drug reduces blood pressure and heart rate, inhibits respiration in higher doses, and has an aconitine-like effect on the conductor system. Externally, the drug causes severe irritation to the skin, including numbing and poisoning through absorption.
Indications & Usage
Unproven Uses
Internally, White Hellebore is used for the treatment of vomiting, cramps, diarrhea, cholera, and bradycardia, and Graves' disease. Externally, the drug is used for neuralgia, rheumatism, joint pain and gout pain.
Homeopathic Uses
White Hellebore is used for neuralgia, infections, diarrhea, hypotension, and as a stimulant.
Precautions & Adverse Reactions
The drug is severely toxic and has numerous severe side effects, even at therapeutic dosages. It is no longer administered in allopathic medicine for that reason. The veratrum alkaloids severely irritate mucous membranes. By inhibiting inactivation of sodium ion channels, the resorption of alkaloids has a paralyzing effect on numerous excitable cells, particularly those governing cardiac activity.
Overdosage
The first symptoms of poisoning are sneezing, lacrimation, salivation, vomiting, diarrhea, a burning sensation in the mouth and pharyngeal cavity, and inability to swallow. Then, following resorption, paresthesia, vertigo, possible blindness, paralysis of the limbs, mild convulsions, lowering of cardiac frequency, cardiac arrhythmias, and hypotension occur. Death occurs either through systolic cardiac arrest or through asphyxiation. The lethal dosage is between 10 and 20 mg of the alkaloid mixture, corresponding to 1 to 2 g of the drug. The alkaloids can be absorbed through uninjured skin.
Treatment of poisoning consists of gastrointestinal emptying (inducement of vomiting, gastric lavage with burgundy-colored potassium permanganate solution, sodium sulphate), administration of activated charcoal and shock prophylaxis (appropriate body position, quiet, warmth). Thereafter, spasms should be treated with diazepam or barbiturates (IV), bradycardia should be treated with atropine, hypotension should be treated with peripherally active circulatory medications, electrolyte substitution should be employed, and possible cases of acidosis should be treated with sodium bicarbonate infusions. Intubation and oxygen respiration may also be necessary.
Dosage
Mode of Administration
The drug is used in powders, tinctures and homeopathic dilutions for internal use; preparations made with fatty oils are used externally.
Preparation
Mix 5 g drug with 10 g lanolin and 20 g fat for topical application.
Daily Dosage
Internally, the drug is administered as 0.02 to 0.1 g of powder or 20 to 60 drops of tincture. Externally, the drug is applied as a poultice or compress.
Homeopathic Dosage
5 drops, 1 tablet, or 10 globules every 30 to 60 minutes (acute) and 1 to 3 times daily (chronic); parenterally: 1 to 2 mL s.c., acute: 3 times daily; chronic: once a day (HAB34). The globules are from D2; all others are from D4.
