THUJA.

The branchlets and leaves of Thuja occidentalis, Linné (Nat. Ord. Cupressaceae). Indigenous to Canada and the United States, on the rocky borders of streams and lakes, and in swamps.
Common Names: Arbor Vitae, Yellow Cedar, False White Cedar, Tree of Life.

Principal Constituents.—Oleum Thuja, (Oil of Arbor Vitae), having a camphoraceous odor and tansy-like taste, and composed of dextro-pinene, laevo-fenchone, and dextro-thujone; a bitter glucoside, pinipicrin, and thujin (C20H22O12), an astringent, yellow glucoside closely related to quercitrin.
Preparations.—1. Specific Medicine Thuja. Dose, 1 to 30 drops.
2. Aqueous Thuja. Dose, 1 to 40 drops; chiefly used locally.
3. Long's Thuja, An Ointment of Thuja.

Specific Indications.—Vesical irritation and atony; enuresis due to atony; urinal incontinence in children due to a weak bladder; dribbling of the urine in the aged, not due to paralysis or growths; urine expelled upon exertion as coughing, etc.; catarrhal flow from bladder or genitalia of male or female; chronic prostatitis; warty excrescences, and dry forms of eczema. Locally: fissured anus, prolapsus ani, pruritus in mucous membranes; venereal discharges; trachoma; warts; naevi; urethral caruncles; and hydrocele.

Action.—In small doses thuja is tonic and increases the activities of the kidneys. Large doses may provoke the irritant effects common to the turpentines and balsams. It has been asserted to have caused abortion, a doubtful effect, but attributed secondarily to violent gastric and intestinal irritation, resulting from excessive amounts of the drug. In many respects it resembles the activities of savin; though unlike the latter it is not a poison.

Therapy.—External. Locally thuja is stimulant, subastringent, deodorant and antiseptic. It is especially useful for the restraint and reduction of hypertrophic changes in the mucous and cutaneous tissues. It will deaden and repress fungous granulations, and for this purpose may be applied to "Proud flesh" and "ingrown nail" (both overgrown granulations). Alcoholic preparations of thuja may be employed to retard fungoid granulation and ulceration in epithelioma (does not cure), bed sores, sloughing wounds, fistulae, and to overcome the stench of senile and other forms of gangrene. It has a good record in curing papillomata and condylomata (upon the nates) when soft and there is foul exudation; and often succeeds in controlling venereal or genital warts. Alcoholic preparations of thuja are generally conceded to be the best local and kindly acting vegetable medicines for the dispersal of common warts or verruccae on any part of the body. It is applied locally and with reputed greater success hypodermatically into the base of the growth. Our personal experience with it for the removal of warts has been negative. Rarely it controls bleeding and ameliorates in hemorrhoids and prolapsus ani. Persisted in, though at first painful, it has cured fissure of the anus. Howe valued it for bulging naevi, and his once famous method of curing hydrocele with it is now little practiced. As compared with tincture of iodine or with carbolic acid it is less painful, but unlike the latter free from poisonous consequences through absorption. Howe's method was as follows: Tap and drain the tunica vaginalis testis, and inject two drachms of a solution of specific medicine thuja (one part) in warm sterile water (seven parts). Knead the tissues thoroughly so that the fluid is made to penetrate every part of the sac. More or less burning pain ensues, together with a greater or less degree of swelling; after sub sidence of the latter, if the procedure has been carefully executed, adhesion of the contact surfaces from the inflammation provoked results. Specific medicine thuja has been used to remove urethral caruncle and for the relief of chronic dry eczema of a furfuraceous character. Dropped upon hot water and inhaled it is of benefit in fetid sore throat, chronic and fetid bronchitis, bronchorrhea, and chronic nasal and retro-nasal catarrh. In all of the foregoing conditions the alcoholic preparations may be employed from full strength to such a dilution as the individual cases demand.

Aqueous thuja is invaluable to relieve pain and promote quick healing in soft pultaceous chancroids. It quickly allays pain, checks the discharge and odor, prevents lymphatic engorgement, and stimulates healing. It has no effect upon hard chancre, nor is it in any sense to be regarded as antisyphilitic. Wherever upon sensitive tissues the alcoholic preparations are inadvisable, the aqueous preparation may be substituted. It has been especially useful in catarrhal granulation of the cervix uteri (tampon); its use being preceded by a hot douche. For acute gonorrhea the following injection is most valuable: Rx Colorless Hydrastis; Aqueous Thuja, each 1 part; Warm Water, 4 parts. Mix. Sig.: Inject every three hours. If there is much soreness add one part of Specific Medicine Hamamelis. The same mixture gives good results in subacute and chronic proctitis, following dysentery. Locally applied alone, or in the above-named combination, it may be used upon balanitis, herpetic ulcers, and abrasions and excoriations of the glans penis. As a local wash for mucous erosions in the mouth, for sore nipples, and for chapped hands it is pleasant and often efficient.

Ointment of Thuja is the preferred thuja preparation for granular ophthalmia or simple trachoma. When the granules are soft and pultaceous a wetted alum pencil may be quickly passed over the everted lid, making but one sweep at each treatment. The parts are then dried, especially if the subconjunctival tissue is much infiltrated; and the ointment applied by means of a camel's-hair pencil. This should be done once a day. Fleeting pain is experienced. Absolute cleanliness should be insisted upon when home treatment is carried out, and constitutional remedies administered when conditions warrant them.

Internal. Thuja is stimulant, subastringent, and antiseptic. Internally its effects resemble those of the terebinths, particularly savin, though it is less energetic than the latter. It is employed chiefly for its effects upon the mucous tracts—particularly the broncho-pulmonic and genito-urinary. While it has been advised (by inhalation from hot water) for hemoptysis, we have far better agents for this purpose; but in bronchial affections with excessive and fetid expectoration it is of considerable value and ranks well with other terebinthinates. Its most specific action is upon the bladder controlling urinal incontinence in all forms except those excited by urinary concretions, paretic conditions, worms, or malignant growths. A most marked effect for good comes from its use for the relief of dribbling of urine in the aged and the young, provided paralysis does not exist in the former, or preputial adhesion or phymosis is not present in the latter. Doses of five to ten drops of the specific medicine often relieve nocturnal enuresis in children, when merely functional. Lack of tone in the muscularis mucosae appears to be the indication for it. The bladder seems too weak to prevent leakage, and for this debility it is especially useful when coughing or straining at stool, or the lifting of weighty objects causes an expulsion of urine. The doses mentioned also aid the local use of aqueous thuja in gleet when accompanied by granular urethritis. In habitual bed wetting the following is sometimes more effectual than thuja alone: Rx Specific Medicine Thuja, 30 drops; Specific Medicine Belladonna, 20 drops; Water, enough to make 4 fluidounces. Mix. Sig.: One teaspoonful four times a day. Thuja gives comfort and relief in that unfortunate condition in old men with enlarged prostate in which the urine constantly dribbles, entailing much discomfort and misery, and producing unsightly stains upon the clothing. Whether it has any power to reduce an enlarged prostate has not been determined, but that it relieves weakness of the neck of the bladder is well established. Some claim that thuja is especially serviceable in cystic irritability when associated with eczema or with gout. Like most products of the conifers, thuja sometimes proves emmenagogue and stimulates in atonic amenorrhea when the genital tissues are flabby and lifeless.