Introduction - Uppsala Monitoring Centre

Death 370 BC, 1568,
1651, 1662, 1667,
1798.
N A AVN V
Hahnemann (1825) quotes in his 2 nd edition for Veratrum album from 26 different
historical sources and there are 716 symptoms written in the vernacular from 5
provers, which makes their interpretation difficult (Hahnemann, 1825). He doesn’t
mention stupor, fever or death, but does add more than 6 reports of cough and
chilliness (?fever). There were 4 reports of dilated pupils and 4 for contracted pupils,
other than these and reports concerning the pulse (no measurements of rate) there
was nothing to indicate that a physical examination had occurred.
SE of Drugs 1952 = Meyler’s ‘Side Effects of Drugs’ 1st edition 1952 also
mentions renal damage, pulmonary oedema and cerebral oedema.
Elek = Separate paper by Elek et al in 1953, placed here for convenience.
Album only: tremor, gastric erosion, collapse, skin pricking and restlessness
Niger only: diuresis and tinnitus
Viride only: headache and somnolence
Hellebore is no longer mentioned in the British Pharmacopoeia, but it was in the
US pharmacopoeia of 1898. In 1889 it was said to be no longer used, as it was
obsolete, but still used in domestic animals. The active alkaloids in Veratrum viride
or American hellebore were isolated in 1943 and by 1946 and became a product
named ‘Vertavis’ and was used in clinical practice for hypertension. The adverse
effects of these alkaloids were: fall in blood pressure with collapse, bradycardia,
nausea and vomiting, tightness in the chest, excess salivation, parathesia about the
mouth, joints, hands and feet, and transient blurring of vision (Holley & Koffler,
1950). It was still use in 1962 in hypertension. It is also still available (Micromedex,
2008) in the USA as part of a mixture containing Veratrum viride, hyoscyamus and
phenobarbitone or combined with Rauwolfia. It is difficult to date its demise from
general use, but it was probably due to the change in medical philosophy in that it
was no longer believed that purging patients or making them vomit was helpful. It
wasn’t until after hellebore went out of fashion that the means to discover the
mechanisms for the ADRs were discovered.
The early reports are often general comments and not specific: dangerous 370
BC, 1491, 1619; fatal 370 BC, 1491; poison 49 BC, 47 BC; too violent 1586;
perilous 1657; unhappy remedy 23 BC; not to be taken by old men, weaklings, etc.
78 AD, and frequently the early reports do not differentiate between the various