Family Name: Oleaceae

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Part Used:
Root bark

Chemical Constituents: Significant phytochemicals include Phyllyrin, lignan glycoside, and saponins. (12)

History
The fringe tree grows from Pennsylvania to Georgia and west into Tennessee . It can be seen growing near flat rocks and along riverbanks in sandy soils. The tree produces opulent displays of white flowers that have the appearance of a beard, hence the trees common name old man’s beard. Its scientific name is also refers to its flower. It is derived from two Greek words, chion (snow) and anthus (flower) or snow-flower.

The Eclectics regarded this tree as one of their most valuable indigenous remedies. Despite this, there is no record of this plant being used as a medicine prior to the Eclectic movement. How they came to know the drug is a matter of conjecture. One scenario is this. Many of the Eclectics were from Kentucky where Chionanthus is a common tree. While the Eclectics were living in Kentucky there was still a substantial Native American presence. Knowledge of the drug may have passed from the Native Americans to the Eclectics during their tenure in that state. Regardless of how they came to know it, Chionanthus became a standard in Eclectic practice. All major Eclectic medical texts refer to the drug.

Eclectic uses (1–11)
Actions
Alterative, tonic, aperient, narcotic, catalytic, digestive, diuretic, laxative, promotes assimilation, tonic to the whole system, strongly influences glandular system, detoxifies system of morbid material, cholagogue, antiperiodic, influences the liver and spleen, dynamically influences functional activity of the bile secreting cells, influences blood making organs, arouses cellular activity in the biliary apparatus, tonic to the whole digestive apparatus, intestinal antiseptic in typhoid.

Indications
“Dirty, sallow skin, with expressionless eyes and hepatic tenderness; an icteric hue, with or without pain; hepatic colic; intense pain from liver to umbilicus, attended with nausea and vomiting and great prostration; pain in epigastrium and right hypochondrium, simulating colic, sometimes extending to the abdomen; jaundice, with itching skin and thin, light-coloured, watery stools; tympanites; colic, with green alvine discharges; urine stains the clothing yellow.” (8)

General
Mercurial cachexia, tuberculosis, systemic tuberculosis, syphilis, malaria, jaundice with malarial periodicity, malarial cachexia, improper blood making causing disease, atony, yellowish discoloration of the skin and eyes, with imperfect waste and excretion, malarial conditions with atonicity of the stomach and intestinal apparatus, chill and fever, bilious and typhoid fevers, obstinate intermittent fever, convalescence from exhausting diseases, general debility, general debility with failings of the chylopoietic system.

Cardiovascular
Chronic splenitis, venous congestion.

Digestive
Morbid conditions of the liver, hypertrophy of the liver, obstruction of the liver, malarial obstruction of the liver, jaundice, obstruction of the gall ducts by calculi, gall stone formation and passing, jaundice of years standing, jaundice that comes annually in summer time, irritation of the liver with increased temperature and hardness of the pulse, irritation of the liver with atony, hepatic colic, chronic hepatitis, inflammation or other diseases of the pancreas, chronic gastritis, jaundice associated with periodicity, congestion of the liver, acute and chronic inflammation of the liver, bilious colic, irritable condition of the liver in alcoholism, catarrhal conditions of the bile ducts, dyspepsia with hepatic complications, irritated states of the stomach from high living and alcohol consumption, general inflammatory conditions of the duodenum, chronic inflammatory conditions of the ductus communis coleduchus, infantile dyspepsia, intestinal dyspepsia, infantile and childhood jaundice, gastrointestinal atony.

Endocrine
Diabetes mellitus, patients with no appetite, loosing flesh, listless, increasingly anaemic, with a little sugar in the urine, diabetes with functional derangement of the liver.

Genito-urinary
Chronic nephritis, incipient stages of nephritis, uterine and ovarian congestion.

Lymphatic
Glandular diseases with evidence of imperfect waste.

Musculoskeletal
Rheumatic conditions with soreness in the liver region, rheumatic diathesis.

Nervous
Bilious headaches, irregular or periodical.

Skin
Inflammations, wounds, ulcers.

The drug from Selye’s perspective

State of Resistance
The drug was used to raise resistance to tuberculosis, syphilis, malaria, abnormal blood making, typhoid fever, exhausting disease, nephritis, rheumatism, and diabetes.

State of Exhaustion
The drug was used when the body could no longer resist chronic diseases like malaria, syphilis, diabetes, and rheumatoid arthritis and State of Exhaustion set in. Signs of State of Exhaustion , treated with the drug, included cachexia, temperature abnormalities, atony, general debility with digestive failure, yellowish discoloration of skin/eyes, imperfect waste and excretion, digestive atony, dyspepsia, chronic gastritis, chronic nephritis with lack of appetite, loss of flesh, listlessness, anaemia, and joint abnormalities.

Adaptation Energy
From Selye’s perspective, Chionanthus was used to augment the GAS, which suggests it increases adaptation energy. Evidence to this effect includes the following. It was used to raise resistance to chronic disease including diabetes, kidney disease, malaria, tuberculosis, syphilis, and rheumatoid arthritis. It was used when State of Exhaustion set in. Lastly, it was used topically to stimulate healing in fresh wounds and old ulcers.

Brekhman’s Adaptogen Criterion
An adaptogen should be innocuous and cause minimal disorders in the physiological functions of an organism.

The Eclectics considered the drug safe. (1–11) However, contemporary sources state that in large doses it may cause vomiting, frontal headache, and slow pulse. (13)

The action of an adaptogen should be non-specific i.e. it should increase resistance to adverse influences of a wide range of factors of physical, chemical, and biological nature.

Clinically, the drug was used to increase resistance to syphilis, tuberculosis, malaria, rheumatoid arthritis, diabetes, and kidney failure. (1–11)

An adaptogen may possess normalising action irrespective of the direction of the foregoing pathological changes.

Clinically, the drug was used to correct the physiological abnormalities associated with State of Exhaustion including secretory abnormalities, temperature abnormalities, ulceration of the GIT, mucous membrane irregularities, exhaustion, and weight loss. (1–11)
Discussion

The drug exhibits properties consistent with Brekhman’s definition of an adaptogen. The Eclectics found this drug to be safe, to raise resistance to a wide array of threats to well being, and to normalise physiological abnormalities.

The drug was used when resistance to chronic disease could no longer be maintained and constitutional collapse was imminent. The terminal phase of malaria, tuberculosis, diabetes, and syphilis were all remedied with the drug. However, it was especially used when malaria was at the root of the State of Exhaustion . The drug was used throughout the malarial districts in the US and physicians reported great success with it.
Potential clinical applications

The drug may have utility in chronic disease when constitutional collapse is looming. More specifically, the drug may have a role in preventing or treating malaria.

Future research
• Chionanthus virginica and its chemical constituents. There is little known about the chemical make up of this drug. Its constituents should be investigated.

• Chionanthus virginica and its effects on the GAS. The drug should be tested in the animal model to establish its effects on the GAS.

• Chionanthus virginica and Diabetes. The drug was used very specifically to increase resistance to diabetic disease. It was used when the patient was resisting diabetes and when the patient was collapsing due to diabetes. Its role in raising resistance to type I and type II diabetes should be examined.

• Chionanthus virginica and malaria. This drug was one of the Eclectics favourites for raising resistance to malaria, both acute and chronic. Its role in raising resistance to malarial contraction and infection should be examined.

Eco-availability
The drug is available in the wild and is readily grown.

References for Chionanthus virginica
• Scudder, J. M. Specific Medication and Specific Medicines. Revised. Fifth Edition. Wilstach, Baldwin and Company. Cincinnati . 1874. P. 108.
• Scudder, J. M. the American Eclectic Materia Medica and Therapeutics. Published by the Author. Cincinnati . 1883. P. 499.
• Kilgour, JC. Symptomatic Indications Verified by the Author. Published by the Author. New Richmond , Ohio . 1887. P. 30.
• Watkins, Lyman. An Eclectic Compendium of the Practice of Medicine. John M.Scudder’s Sons. Cincinnati . 1895. P. 430.
• Webster, HT. Dynamical Therapeutics—A work devoted to the Theory and Practice of Specific Medication with special references to the newer remedies. Webster Medical Publishing Company. Oakland . Second Edition. 1898. P. 342.
• Felter, Harvey Wickes and Lloyd, John Uri. Kings’ American Dispensatory. Volume one and Volume two. Ohio Valley Company. Cincinnati . 1898. P. 500.
• Felter, Harvey. Syllabus of Eclectic Materia Medica and Therapeutics. Compiled from notes taken from the lectures of F.J.Locke. Edited with pharmacological additions by H.W.Felter. Second edition, with appendix. Scudder Brothers Company. Cincinnati.1901. P. 363.
• Peterson, F.J. Materia Medica and Clinical Therapeutics. Published by the Author. Los Olivos , California . 1905. P. 68.
• Fyfe, John William. Pocket Essentials of Modern Materia Medica and Therapeutics. The Scudder Brothers Company. 1903. P. 86.
• Ellingwood, Finley. American Materia Medica, Therapeutics, and Pharmacognosy. Ellingwood’s Therapeutist. Chicago . 1919. P. 314.
• Lloyd’s dose book of specific medicine. Lloyd Brothers. Cincinnati . 1907. P. 96.
• Scientific committee. British Herbal Pharmacopoeia. British Herbal Medicine Association. Bournemouth . 1991. P. 63.
• Foster, Stephen and Duke, James. Eastern and Central Medicinal Plants. Houghton Mifflin Company. Boston . 1990. P. 270.

Notes from Eclectic Physicians

1874: Scudder
This agent comes to us with recommendation of Dr I. J. M. Goss, of Georgia, who says:

“It possesses important alterative properties. As a catalytic, it has the most decided influence over the glandular system of any article I have tried. It pervades the whole system, combining with the materies morbi, and conveying it out of the system. I have used it in mercurial cachexy with the most happy success, in quite a number of instances. But the most important therapeutical property that it possesses, it its specific power over morbid conditions of the liver. I have tried it in hypertrophy of that organ, and with uniform success; and also in obstruction of the liver, in malarious districts, with liek success. Some years ago I called the attention of the profession to its specific effects in jaundice, and gave several cases in proof of the fact. Since then I have used the Chionanthus in a great many cases of jaundice, and have never failed to remove it in but one single case, and that one I think was a case of onstruction of the gall ducts by calculi; in that case, I tried all the reputed cholagogues, without success. It removes jaundice of years standing, in from eight to ten days. I have treated several persons that had been subject to jaundice, annually, in summer, for several years, and had been dosed with blue pill, calomel, and other articles, without any benefit, and I have not failed in a single instance, to remove the disease entirely. And when it is relieved with the Chionanthus, it does not return; at least it has not, in any instance to my knowledge. It is as near a specific in jaundice, as quinine in periodicity. The mode in which I have used it is to make a tincture of the bark of the root in gin, say eij. to the quart of gin, and give 3ss. of this every three hours, or the fluid extract, and give from one to two drachms every three hours.”

1883: Scudder (alterative) (The bark of Chionanthus Virginica – U.S. )
Preparations – Tincture of Chionanthus.

Dose – From one to twenty drops.

Therapeutic Action -This remedy exerts a specific influence upon the liver and spleen, and blood-making organs, and when a wrong of blood-making is the cause of bad blood it may be used for the general purposes of an alterative. But it is especially a remedy in jaundice and biliary calculi. In doses of five drops every two hours, it may be given in any form of jaundice. When there is irritation of the liver, with increased temperature and hardness of the pulse, it will be associated with Veratrum or Aconite; when there is marked atony, with Nux, Leptandra, or Podophyllin.

In hepatic colic – gall stones – it is the most certain remedy of the materia medica. In some cases we will combine it with Nux, in others with Dioscorea, and in other with chloroform. In these cases the dose may be repeated every half hour.

We use it in chronic hepatitis, chronic splenitis, inflammation or other disease of the pancreas, and some cases of chronic gastritis. It may be employed in any cases showing yellowish discoloration of skin and eyes, with imperfect waste and excretion, with a prospect of advantage.

1887: J.C. Kilgour, M.D.: Chionauthus ‘Symptomatic Indications’
The symptoms indicating this remedy are a pumpkin yellow colour of the skin, eyes, finger-nails, and root of the mouth. The tongue is slightly paler than usual, with a whitish grey coating. The bowels often loose, with a greenish acid discharge, or sometimes foamy, yeasty stools. The tincture should be mixed with water in the proportion of fifteen drops to four ounces of water, and a tea-spoonful of this solution should be given every two to four hours.

1895: Watkins: CHIONANTHUS, SP MED
Pain in epigastrium and right hypochondrium, simulating colic, hepatic pain, yellowish tinge of conjunctiva, jaundice, pale, thin, watery stools, itching in skin, nausea, tympanites. Two to five drops in four ounces of water; teaspoonful every four hours.

1898: Webster
The fringe tree is a reliable remedy to dynamically encourage the functional activity of the bile secreting cells. It is the leading remedy with a large majority of modern Eclectics in the treatment of jaundice, if the trouble depend upon want of activity in the secretory function of the biliary apparatus. Where there is obstruction to the flow of bile along the ducts we cannot expect so much from it.

Professor Goss was first to call attention to the virtues of this remedy, I believe, and he has given us one of the best in the materia medica. He asserts that he was led by mere accident to test the tonic and cholagogue powers of this shrub. He had been salivated several times for jaundice following intermittent fever and had given up to die, when a fellow student induced him to try the “old woman’s remedy”, chionanthus. This grew plentifully on the sandy soil about Augusta , Georgia , where he was attending lectures. He took a tablespoonful of a tincture made in gin before each meal, and in ten days was practically well, the jaundice having departed and appetite and digestion being restored.

It is a splendid remedy for the jaundice of malarial cachexia, and in chronic ague complicated with jaundice its use will assist very much in effecting a cure. I have cured many stubborn cases of the kind with chionanthus and arseniate of quinia.

It should be remembered that it is not the remedy to relieve jaundice due to inflammatory action of the liver or obstruction of the biliary ducts. It is only adapted to torpor of the bile-secreting functions where something is needed to arouse cellular activity in the biliary apparatus.

Form for Administration- The specific medicine.

Dose- From two to fifteen drops.

1901 : Harvey W Felter (Alternatives) – CHIONATHUS- FRINGE TREE
SYNONYM – Old Man’s Beard

BOTANICAL ORIGIN – The bark of the root of Chionanthus virginica , Linne; Nat. Ord., Oleaceae. Southern and Middle States.

SPECIFIC CHIONANTHUS -This preparation has the rank odor of the drug and a dark amber color. By age it casts a gelatinous precipitate that does not interfere with the value of the remedy. All attempts to avoid this phenomenon have resulted in injury to the preparation.

The special action of this drug is expended upon the liver and to some extent on all the organs concerned in blood-making. It is tonic to the stomach and bowels, and influences the whole glandular apparatus. It is one of our best cholagogues, and we have employed it with good results in jaundice and congestion of the liver. Yellowness of the conjunctiva and skin, uneasy sensations in the right hypogastrium , and extensive abdominal pain, somewhat resembling colic, are the specific indications for its use. It may, therefore, be employed in cases on gall-stones, both during their formation and passage, hepatic inflammation (acute and chronic), bilious colic, and for irritably condition of the liver common in the inebriate.

The specific Chionanthus is the best form and should be given in from one to twenty drop doses three times a day.

1905: Peterson
Properties: Aperient;cholagogue; mildly diuretic.

Indications: Clay colored stool, high colored urine, yellowness of skin and conjunctiva result of jaundice. Itching of the skin result of absorption of bile and jaundice. Sense of uneasiness in right hypochondrium or abdominal pain stimulating colic. Where there is torpor of the bile secreting functions, it will arouse cellular activity of the biliary apparatus.

Use: It overcomes the catarrhal conditions of the bile ducts, thins the bile, and prevents formation of calculi and favoris the passage of those formed. In jaundice, acute or chronic congestion of the liver with deficient discharge of bile or catarrh of the bile ducts it is our best remedy when indicated. In jaundice from occlusion of the bile ducts, impacted gallstones or obstruction from a tumor growth it of course is of no value. It acts nicely with iris versicolor, polymnia, podophyllym, leptandra, or sodium phosphate.

1909: Felter and Lloyd: CHIONANTHUS – FRINGE-TREE
History – Chionanthus is one of our most striking and beautiful southern shrubs, and is often cultivated in gardens and parks for its ornamental beauty. We regard it as one of our most valuable indigenous remedies. The fringe-tree, as it is commonly called, grows from Pennyslvania to Georgia and Tennessee , thriving in sandy soils, in elevated situations, near flat rocks, and along river banks. The tree, when in blossom (May and June), presents a beautiful appearance, being snow-white, hence its common names of old man;s beard, old man’s gray beard, snowdrop-tree, and white ash. It is also known as poison ash. The name chionanthus (pronounced kio-nan thus) is derived from two Greek words, chion (snow) and anthus (flower, or blossom), hence, snow-flower. The bark of the root is the part used, and imparts its properties to water or alcohol.

Action, Medical Uses, and Dosage – Chionanthus acts principally upon the abdominal glandular organs, and to some extent upon the venous system, relieving congestion. It is an alterative in the Eclectic meaning of that term. While its main action is upon the visceral glands, especially the blood-making organs, its influence is also quite marked in other secretive structures. Besides its pronounced catalytic properties, it is diuretic, tonic, and is said to be aperient and narcotic. It is exceedingly doubtful if the latter statement be true and its aperient property, if it possesses such, is the result of its cholagogue action.

Prof. King, in former editions of the American Dispensatory, states that in bilious and typhoid fevers, as well as in obstinate intermittents, the infusion of the bark of the root is efficient. While the remedy is now but very little used for these conditions, still some “old school” authors, as well as some trade catalogues, seem to have appropriated the above statements in regard to its use. Prof. King further states that it is an excellent tonic in “convalescence from exhaustive diseases,” and that it also proves a good local application in external inflammations, ulcers and wounds. The use of an infusion of the bark of the root is directed, still it is doubtful whether such a preparation would be as efficient as an alcoholic form, for the resin, or the resinoid, the active constituent of the drug, is insoluble in water. Goss …….. that the infusion is wholly inert. Chionanthus improves the appetite, aids digestion, promotes assimilation, and is a tonic tot he whole system. It never produces catharsis, but ptyalism has resulted from its use.

Chionanthus has been successfully used in mercurial cachexia, scrofula, and syphilis, though we possess better agents for these classes of disease. Yet, if the patient be sallow, or yellow, and has hepatic pains, the remedy will prove a valuable accessory agent in hastening the cure.

It is for its prompt and efficient action in hepatic derangements that we most value fringe-tree preparations. If there is any one thing true in specific medicine, it is that chionanthus has a decidedly specific action in jaundice. The credit of having brought this remedy before the profession, for the purposes for which it is now used, belongs to the late Prof. I. J. M. Goss, of Georgia, who, in 1843, tested it on himself while suffering from an attack of jaundice, and reported the result in an eastern journal. Since then it has come to be the first remedy thought of for this complaint. Goss considered it the best remedy for all cases of jaundice, not dependent on gall stones. On the contrary, Prof. Scudder was high in his praise of it, even when calculi are present. He recommended it in 10 or 15-drop doses during the paroxysm, and also gave it to prevent a recurrence. Nux or dioscorea may be associated with it when called for, the former in atonic conditions, with broad, expressionless tongue, the latter in irritative states, the tongue being red, pointed, and elongated, with prominent papillae. Hypertrophy of the liver, chronic hepatic inflammation, and portal congestion are speedily relieved by chionanthus. The remedy acts quickly, often removing in from 1 to 2 weeks, an icteric hue that has existed for months, and even years. Jaundice once cured by it is not apt to recur. There are two direct indications for the drug – jaundice, as evidenced by the yellowness of skin and conjunctiva; and soreness and pain, “hepatic colic,” as pointed out by Prof. Scudder. The latter is by far the most direct indication. There is the dull, heavy pain in right hypochondrium, with a feeling of fullness and weight, deep-seated tenderness and soreness on pressure, occasional hectic flushes, light colored feces, sometimes diarrhoea with frothy, yeasty stools, and urine scanty and high colored.

These conditions, with the icteric hue of skin and conjunctiva, call for chionanthus. Sometimes the patient writhes in pain, can not find rest in any position. R Specific chionanthus, gtt. x, every half hour, and apply a cloth wrung out of hot water. In dyspepsia, with hepatic complications; in irritative states of the stomach from “high living”, and the use of alcoholic stimulants; and in general chronic inflammatory conditions of the duodenum, and ductus communis choledochus, chionanthus serves a useful purpose. It is also a good remedy in infantile dyspepsia. Rheumatic affections, with soreness in the region of the liver, and a jaundiced condition, are ameliorated by this drug. Its tonic effects on the chylopoietic viscera render it a good agent in general debility. In intestinal dyspepsia, with jaundice, thin, watery, yeasty alvine discharges, with previous abdominal distension: R Specific chionanthus, gtt. v, every 2 hours.

Chronic splenitis and nephritis are conditions in which fringe-tree often proves a good remedy; also in pancreatic disease, inflammatory or otherwise. Glandular diseases, with evidence of imperfect waste, often call for its administration. Chionanthus is of utility in uterine an dovarian congestion, when the usual hepatic symptoms calling for it are present. If there be fullness and bearing down in the pelvic viscera, especially a desire to frequently evacuate the rectum, combine it with specific helonias. R Specific chionanthus, specific helonias, aa fl3j; aqua q.s., 3iv. Mix. Sig. Teaspoonful every 2 hours.

Dose, from 1/2 fluid ounce of the infusion to 2 fluid ounces, repeated several times a day, according to its influence upon the system. The usual dose of specific chionanthus (the best preparation), is 10 drops in water every 3 hours. Chionanthin, the so-called concentration, is of little value and is but seldom used. It was first prepared by Prof. Goss.

Specific Indications and Uses -Dirty, sallow skin, with expressionless eyes and hepatic tenderness; an icteric hue, with or without pain; hepatic colic; intense pain from liver to umbilicus, attended with nausea and vomiting and great prostration; pain in epigastrium and right hypochondrium, simulating colic, sometimes extending to the abdomen; jaundice, with itching skin and thin, light-colored, watery stools; tympanites; colic, with green alvine discharges; urine stains the clothing yellow.

1911: Fyfe
Skin resembling copper in color, but shading a litte more on green, pain in the epigastrium and right hypocondrium, yellowish or greenish discoloratin of the eyes. In jaundice and chronic inflammation of the liver, spleen or pancreas, chionanthus is a superior remedy. Chionanthus virginica is alterative, diuretic, and laxative. In very large doses it is slightly narcotic.

1919: Ellingwood: CHIONANTHUS – CHIONANTHUS VIRGINICA
Synonym – Fringe Tree.

Constituents – Chionanthin, saponin.

Preparations – Specific Medicine Chionanthus. Dose, ten to twenty minims.

Specific Symptomatology – The specific influence of the agent is exerted upon the liver. It is a remedy for hepatic engorgement; jaundice more or less pronounced; pain over the region of the gall bladder; pain in the epigastrium; pain radiating from the navel over the abdomen; soreness in the region of the liver, extending to the umbilicus; enlargement of the liver, determined by percussion; nausea; occasional vomiting; constipation with dry feces; temperature slightly above normal; skin usually yellow. This latter indication – a distinctly yellow skin – has always been my immediate suggestion for chionanthus and I have rarely been disappointed.

Therapy – It is a cholagogue cathartic in full doses, but its best influence is in acute congestion of the liver with imperfect discharge of bile, or catarrh of the common bile duct. We have no agent more certain in its action when indicated. The indications are acute jaundice evidenced by yellowness of the conjunctiva first, subsequently of the skin, with distress in the right hypochondrium, with cramp-like pains in the abdomen.

It overcomes catarrh, liquefies the bile, prevents the formation of calculi, and promotes the discharge of those formed. It is a remedy for chronic forms of liver disease, but its influence is not so plainly apparent, being much slower in its operations. It is not indicated in jaundice from permanent occlusion of the duct, from impacted gall stones or foreign and malignant growths.

Bilious headaches resulting from liver faults especially if irregular or periodical are cured by chionanthus.

The action of chionanthus in the treatment of tobacco habit must be studied. It has an influence in many cases.

It will quickly overcome the jaundice of childhood and infancy, and especially sure in the jaundice of the pregnant term. It is an excellent remedy for malarial conditions with atonicity of the stomach and intestinal apparatus. It can be given during the chill and fever, and it assists greatly in the relief of both. The agent may be pushed to the maximum dose and given with full confidence when indicated, as it is absolutely certain in its action. It is sometimes best given in infusion.

Dr. Fearn claimed to have early made the discoery of the use of chionanthus in reducing the quantity of sugar in the urine. Patients with no appetite, losing flesh, listless, increasingly anemic with a little sugar in the urine were those to whom he first gave it, ten drops four times a day. Later he used it in severe cases of diabetes mellitus. Dr. A. P. Hauss, of New Albany, Ind., has had manyyears’ experience in the observation of this remedy in the treatment of this disease. He has much confidence in it.

Dr. Halbert of Nashville confirms this influence.

Probably in those cases in which this remedy is beneficial in diabetes there is functional disease of the liver.

Whether the remedy would be equally beneficial in cases in which no liver fault could be diagnosed, might be questionable, and yet Hauss says that he has never treated a case of diabetes mellitus along the lines indicated that has not yielded to this treatment. He prescribes from ten to fifteen drop doses of chionanthus, four times daily. If no febrile condition is present or if there is general atonicity, with nervous depression, he adds from one-half to one drop of nux vomica. He has the patient drink from one to two pints of hot water each morning, before breakfast, to which he adds a small teaspoonful of the sulphate of magnesium, or in preference one-half wine glass of French Lick Pluto water in a pint of hot water. This treatment, with proper dietary, he claims, has a rapid effect upon the glycosuria, immediately reducing the specific gravity of the urine.

The agent is beneficial in chronic splenitis, pancreatic disease and disease of the other glandular organs; also in the incipient stages of nephritis. In the line of its symptomatology, it is an exceedingly satisfactory remedy. It influences the stomach in the process of digestion; it exerts a beneficial, stimulating effect upon the entire glandular apparatus.

Prof. Ralph Morrill gives the following as important in the application of this remedy: In the obstruction of the bile ducts, due to inflammation of the duodenum, this remedy is directly indicated. He gives it as an intestinal antiseptic in typhoid fever. He believes its influence is exercised by its stimulating effect upon the flow of the bile. He has had clinical evidence of its undoubted value in many difficulties of the gastro-intestinal tract, which are cured by this important influence. He combines it in some cases of gastro-intestinal atony, with nux vomica and podophyllum, in the following prescription: Nux vomica, fifteen drops; chionanthus, two and a half drams; podophyllum, one and a half drams; elixir of lactated pepsin, sufficient quantity to make four ounces. Of this give one dram three times a day.

In perverted functional action of the liver, resulting in the excretion of an abnormal quantity of uric acid, which interferes with the evolution of proper metabolism present in the formation of urea, and its products, it is a valuable remedy. It is thus of much importance in the treatment of acute lithemia – toxemia, from excess of urea or uric acid, and the rheumatic diathesis.

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