American Materia Medica, Therapeutics and Pharmacognosy

Pawinsky rarely met with unfavorable effects on the digestion from this
remedy, of which effects some authors speak very extensively. Cumulative
effects he found none.
The indications for the remedy, according to the writer mentioned, are
valvular lesions and affections of the heart muscle at the time of
disturbance of compensation. A. Robin gave thirty drops of this remedy
three times daily.
Its influence upon the kidneys is exercised, however, when heart
symptoms are not conspicuous. It produces a greatly increased flow of
limpid urine without irritating the kidneys. There is no hematuria or
other evidence of forced action or marked renal congestion. In profound
doses it has caused suppression of the urine.
The agent exercises a hydragogue influence both upon the kidneys and
bowels. In large doses it irritates the stomach, producing violent
prostrating emesis. As an emetic or cathartic it is too harsh and should
not be used. We have more efficient and milder remedies.
Dr. Gregory believes apocynum acts directly on the kidneys and when
they are acting insufficiently he uses it as a stimulant, believing that it
increases the solid matter thrown off. Dr. Moercke, of Burlington, believes
that the remedy will not act when dropsy is induced by malignant
diseases, but may perform miracles where the patient is dying from
incurable heart lesions with general dropsy. He finds it of great value in
articular rheumatism when the tissues are filled with serum, and the
heart weak but sound.
The following conclusions were drawn by a writer in the Medical
Century:
The drug may be given in large doses for a long time—several years in a
few cases—without injury to the patient.
Improvement soon manifests itself in the majority of cases, but if
improvement does not appear soon after taking the drug its further
administration will be of no avail.
The best way to give the drug is by starting in with small doses of the
tincture—three drops—and gradually increasing the dose so that the
patient is taking ten drops three times a day within three days.
Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 40