CAULOPHYLLUM.

The rhizome and roots of Caulophyllum thalictroides (Linné), Michaux (Nat. Ord. Berberidaceae). In rich woods in the eastern half of the United States.
Common Names: Blue Cohosh, Squaw-root, Pappoose-root.

Principal Constituents.—An indifferent alkaloid caulophylline (not to be confused with the resinoid "caulophyllin,") and an active glucoside of the saponin type, leontin.
Preparations.—1. Specific Medicine Caulophyllum. Dose, 1 to 10 drops.
2. Leontin (Lloyd's) , a 1 per cent solution of leontin, the emmenagogue principle of caulophyllum. Dose, 5 to 15 drops in syrup or sweetened water.
3. Syrupus Mitchellae Compositus, Compound Syrup of Mitchella (Compound Syrup of Partridge berry). Dose, 1-4 fluidounces.
Specific Indications.—Uterine pain with weight and fullness and pains in the legs; sense of pelvic congestion; sluggish labor pains; as a partus praeparator.

Action and Therapy.—Caulophyllum was at one time largely used as an antispasmodic, emmenagogue, parturient, diuretic, diaphoretic and expectorant, all of which properties it possesses in greater or less degree, according to its manner of use. It unquestionably acts with some force upon the reproductive organs of women, overcoming pain and tenderness in debilitated subjects. It seems best adapted to uterine debility arising from chronic inflammatory conditions. In many respects it resembles macrotys (cimicifuga), both upon the reproductive organs and in controlling rheumatoid pain. For many years it was a favorite remedy for false pains and afterpains. It, like macrotys, facilitates child-birth. Both agents produce contractions most like those of the natural labor process. In this respect they were often used to replace tetanic-acting ergot when that agent was so popular and so damaging as an oxytocic. It may be used to assist labor when delay is due to weakness, fatigue, or lack of uterine power, or when the tissues feel full, as if congested. The skillful use of forceps has largely supplanted drugs of this type, yet there are many cases in which they might still be used with greater safety than forceps. As an ingredient of the Compound Syrup of Mitchella (Mother's Cordial), it is still relied upon by some physicians as a good partus praeparator.

Caulophyllum is a good emmenagogue. It may be used where there is congestion with irritation, and the natural functions are badly performed. In troubles dependent upon such irregularities, it has given fair results, though macrotys has supplanted it for most conditions. Metritis, endometritis, amenorrhea, dysmenorrhea, ovaralgia, ovaritis, rheumatism of the uterus, menstrual cramps, uterine subinvolution, and spasmodic retention of urine have all been favorably influenced by caulophyllum. It is of some, though minor, value in spasmodic urinary and gastro-intestinal disorders.

Leontin (1 per cent solution of the emmenagogue principle of caulophyllum) has been successfully prescribed for amenorrhea, dysmenorrhea, and chlorosis. The dose of leontin is 5 to 15 drops in syrup or sweetened water.

Compound Syrup of Mitchella may be given for weeks as a uterine tonic preceding labor. It seems to have both a real and a psychic influence that will redound to the benefit of the prospective mother. It is also a good uterine tonic for debility and uterine feebleness in the childless, and assists in the recuperation of strength and rapid involution of the womb following labor. The dose of the syrup is from 2 fluidrachms to 1/2 fluidounce, 2 or 3 times a day.