EUPATORIUM PERFOLIATUM.

The flowering tops and leaves of Eupatorium perfoliatum, Linné (Nat. Ord. Compositae). Swamps and low meadows throughout the United States. Dose, 5 to 60 grains.
Common Names: Boneset, Thoroughwort, Indian Sage, Ague Weed, Through-Stem, Thorough-Wax, Crosswort, Vegetable Antimony.

Principal Constituents.—Volatile oil, tannin, and a soluble, bitter glucoside—eupatorin.
Preparations.—1. Specific Medicine Eupatorium. Dose, 5 to 60 drops.
2. Infusum Eupatorii, Infusion of Boneset. Dose, 1 to 4 fluidrachms.

Specific Indications.—Large full pulse, the current showing little waves; skin hot and full, with a tendency to become moist, even during the progress of fever; deep-seated aching pain (so-called "bone pains") in muscles and periosteum; cough, embarrassed breathing, and pain in the chest; urine turbid and urination frequent; influenzal cough and aching pain.

Action.—Eupatorium, in small doses, acts as a simple bitter; in large doses it is emetic. Given in hot infusion it causes both emesis and profuse diaphoresis; sometimes catharsis also results. In cold infusion, or small doses of the alcoholic preparations, it is tonic and aperient. It also has marked but unexplainable antimalarial properties.

Therapy.—Eupatorium is an old American drug that has found its way into general medicine through aboriginal and domestic usage. Formerly it was a favorite emetic and was successfully used at the outset of fevers of the bilious remittent and intermittent types. Its antiperiodic properties were well known and used to advantage in ague districts many years ago. Its property of relieving deep-seated pain was also early recognized, obtaining for it the vulgar name of "Boneset". It is now seldom, or never, used as an emetic chiefly because emetics are not often employed, and also on account of the bitterness of the drug and the quantity of infusion required. Its thoroughness as such, however, cannot be questioned, and it has no poisonous or depressing qualities. Eupatorium is now used in malarial affections of the irregular and masked types, and particularly those not benefited by quinine. The chill and succeeding fever are slight, the skin dry, and not, as a rule, followed by perspiration; there is deep-seated, aching pain, as if "in the bones", praecordial oppression, and great thirst. If, however, the fever lasts all day, slight sweating may occur at night. An added indication in ague is vomiting, especially of much bile. Formerly the hot infusion was given to emeto-catharsis, and followed during the intermission with tonic doses of the cold infusion. This is now known to be unnecessary, full doses, short of nausea, of the alcoholic preparations being fully as efficient. Malarial headache, with irregular intermittence, is also relieved by small doses of the drug.

Eupatorium is an admirable remedy "to break up a common cold," especially when accompanied by deep-seated, aching pain and slight or no fever. If there are pleuritic pain and hoarseness, it is also valuable. In every epidemic of influenza it has been used with great advantage. During the severe pandemic of 1918-19 it was one of the safest and most successful remedies employed and contributed much to the successful management of the disease under Eclectic treatment. By many it came to be used as a prophylactic, persons taking it freely apparently escaping attack. Notwithstanding this, its prophylactic power, if it has any, is as yet unexplained and should not be seriously relied upon. That cases were rendered milder, deep-seated pain promptly relieved, cough and respiratory irritation lessened, and recovery expedited under the liberal administration of eupatorium is a matter of record. It is especially valuable to relieve the intolerable backache and pain in the limbs. Eupatorium often relieves periosteal pain of a neuralgic type, particularly if associated with malarial infection, but it renders no service in that caused by inflammation or by syphilitic or other organic changes in the periosteum.

In respiratory affections boneset is efficient to relieve cough, acting best in that occurring in the aged and debilitated, where there is an abundance of secretion, but lack of power to expel it. It also relieves hoarseness, and sometimes benefits in humid asthma. It is one of the best of medicines to relieve the irritable cough of measles, but care must be taken not to push its effects to nausea and vomiting. For children it is best administered in an aromatized syrup. In pneumonia it relieves chest pains and cough, and for these purposes may be employed in the early stage of acute lobar, but more effectually in broncho-pneumonia. After the active stages have passed it again becomes useful to allay the irritable after-cough and to assist in expectoration when bronchorrhea occurs. Being tonic and stomachic, when given in small doses it improves the appetite and digestion and thus favors a more rapid and perfect convalescence.