American Materia Medica, Therapeutics and Pharmacognosy

In the influence of this remedy upon the capillaries of the skin, loading
them up so actively, there is a contributory influence upon the capillaries
of the spinal cord, which decreases the amount of blood in this locality,
exercising often an exceedingly beneficial influence, especially when
the patient suffering from spinal or cerebral congestion has cold skin,
cold extremities, a cold, clammy sweat, dilated pupils, and great
sluggishness of action. In this case, the remedy is absolutely specific and
invariable in its influence.
Belladonna acts directly upon the heart. It is a pure stimulant to this
organ, through its influence on the cardiac muscle and accelerator
nerves. Previously it was thought that this drug increased arterial
pressure. This now is considered doubtful, as positive proof is lacking.
Notwithstanding the lack of proof in the laboratory, in the individual
there is more force in the pulse, and there is extreme activity, as stated
above, in the capillary circulation, especially when there is profound
congestion, with cold relaxed skin, difficult breathing from pulmonary
hyperemia, with a small compressible pulse and a deathlike pallor,
followed, in extreme cases, by cyanosis. Then the stimulating influence
of 1/80 or 1/60 of a grain of atropine will show itself unquestionably in a
very few moments. This influence is very general. Strychnine expends its
influence upon the nerve-centers, but the influence of atropine is upon
the peripheries in an unquestionable manner, making it probably the
most active of the diffusible stimulants. In this rap. idity in removing the
blood from the lung-cells it increases oxidation. It thus relieves the
pulmonary hyperemia, overcomes cyanosis and promotes free, deep
breathing.
Specific Symptomatology—There is a characteristic syndrome present
in congestive types of many diseases which rationally indicates the need
for belladonna. Preliminary congestion is a common condition in very
many diseases and the influence of this drug, in antagonizing
congestion and in producing a normal and effective equalization of the
circulation brings it first to the mind of those who are studying actual
conditions, in an endeavor to decide upon the needed remedy.
The syndrome referred to consists in chilliness, mental dulness, and
inactivity; dull eyes with dilated pupils, eyes partly open when asleep;
skin cool and relaxed, with occasional free sweating; cool extremities;
general sluggish capillary circulation.
Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 62