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<h2>THE USE OF THE MULLEIN PLANT IN THE TREATMENT OF PULMONARY CONSUMPTION.</h2>
<p>[Footnote: From a paper published in the <i>British Medical
Journal</i>.]</p>
<h3>By F.J.B. QUINLAN, M.D., M.R.I.A., F.K.Q.C P., Physician to St. Vincent's Hospital, Dublin.</h3>
<p>From time immemorial, the <i>Verbascum thapsus</i>, or great
mullein, has been a trusted popular remedy, in Ireland, for the
treatment of the above formidable malady. It is a wild plant--most
persons would call it a weed--found in many parts of the United
Kingdom; and, according to Sowerby's <i>British Botany</i>, vol.
vi., page 110, is "rather sparingly distributed over England and
the south of Scotland." In most parts of Ireland, however, in
addition to growing wild it is carefully cultivated in gardens, and
occasionally on a rather extensive scale; and this is done wholly
and solely in obedience to a steady popular call for the herb by
phthisical sufferers. Constantly, in Irish newspapers, there are
advertisements offering it for sale; and there are, in this city,
pharmaceutical establishments of the first rank in which it can be
bought. Still it does not appear in the Pharmacopoeia; nor, as far
as I know, has its use received the official sanction of the
medical profession. Some friends with whom I talked over the matter
at the Pharmaceutical Conference at Southampton last August,
suggested that it would be desirable to make a therapeutical
research into the powers of this drug, and ascertain by actual
experiment its efficacy or otherwise. Having partially accomplished
this, I am anxious to very briefly set forth what has been done, in
order that others may be induced to co-operate in the work.</p>
<p>"There are five mulleins, all belonging to the parent order of
the Scrophulariaceæ; but the old Irish remedy is the great
mullein, or <i>Verbascum thapsus</i>, a faithful delineation of
which will be found in Plate 1, 437, vol. vi., of Sowerby. It is a
hardy biennial, with a thick stalk, from eighteen inches to four
feet high, and with very peculiar large woolly and mucilaginous
leaves, and a long flower spike with ugly yellow and nearly sessile
flowers. The leaves are best gathered in late summer or autumn,
shortly before the plant flowers. In former times it appears to
have been rather highly thought of, particularly as a remedy for
diarrhoea; and Dioscorides, Culpepper, and Gerarde favorably allude
to it.</p>
<p>"Having been furnished with a good supply of fresh mullein from
a garden near this city, where it is extensively grown, I commenced
operations. As it proved useful, subsequent supplies were procured
from our drug-contractor.</p>
<p>"The old Irish method of administering the mullein is to place
an ounce of dried leaves, or a corresponding quantity of the fresh
ones, in a pint of milk; to boil for ten minutes, and then to
strain. This strained fluid is given warm to the patient, with or
without a little sugar. It is administered twice a day; and the
taste of the mixture is bland, mucilaginous, comforting to the
praecordia, and not disagreeable. I resolved to try this method,
and also the watery infusion; and, moreover, the natural expressed
juice fortified with glycerin. This latter preparation was
carefully made for me, from fresh mullein leaves, by Dr. John
Evans, chemist to the Queen and the Prince of Wales.</p>
<p>"Some phthisical sufferers, of whom there are here, alas! too
many, were now admitted from time to time into St. Vincent's
Hospital. They were admitted in all stages, from an early one to
the most advanced. On each admission the case was carefully
examined; the history, symptoms, and physical signs were exactly
noted; and the patient was weighed on a stage balance with great
accuracy. The patient was put as much as possible on the mullein
treatment only. For obvious reasons, no cod-liver oil, koumiss, or
other weight producer was given; the patients got the diet suitable
to such sufferers; and, if the special symptoms became troublesome,
received appropriate treatment. As much as possible, however, they
were left to the mullein--a proceeding which was entirely
satisfactory to themselves. In addition to the admission weighing,
they were carefully weighed every week, and care was taken that
this should be done as nearly as possible on the same day and hour,
with the same clothes, and, in fact, as much as could be under the
same conditions. In securing this the patients anxiously
co-operated; and it was frequently amusing, but sometimes painful,
to watch the satisfaction or chagrin with which the weekly result
was received. I must here tender my acknowledgments to our zealous,
attentive, and accurate house surgeon, Mr. Denis P. Kenna, by whom
this important, but tedious, duty was discharged."</p>
<p>Dr. Quinlan then refers to several cases, in which the mullein
plant has been tried as a remedy for consumption, and remarks that
these cases, although too few to justify any general conclusion,
appear to establish some useful facts. The mullein plant boiled in
milk is liked by the patients; in watery infusion it is
disagreeable, and the succus is still more so. The hot milk
decoction causes a comfortable (what our Gallic neighbors call
<i>pectorale</i>) sensation, and when once patients take it they
experience a physiological want, and when the supply was once or
twice interrupted, complained much in consequence. That it eases
phthisical cough there can be no doubt; in fact, some of the
patients scarcely took their cough mixtures at all--an unmixed boon
to phthisical sufferers with delicate stomachs. Its power of
checking phthisical looseness of the bowels was very marked, and
experiment proved that this was not merely due to the well known
astringent properties of boiled milk. It also gave great relief to
the dyspnoea. For phthisical night sweats it is utterly useless;
but these can be completely checked by the hypodermic use of from
one-eighteenth to one-fiftieth of a grain of the atropia sulphate;
the smaller dose, if it will answer, being preferable, as the
larger causes dryness of the pharynx, and interferes with ocular
accommodation. In advanced cases, it does not prevent loss of
weight, nor am I aware of anything that will, except koumiss. Dr.
Carrick, in his interesting work on the koumiss treatment of
Southern Russia (page 213), says: "I have seen a consumption
invalid gain largely in weight, while the disease was making rapid
progress in her lungs, and the evening temperature rarely fell
below 101° Fahr. Until then I considered that an increase of
weight in phthisis pulmonalis was a proof of the arrest of the
malady." If koumiss possesses this power, mullein does not; but
unfortunately, as real koumiss can be made from the milk of the
mare only, and as it does not bear traveling, the consumptive
invalid must go at least to Samara or Southern Russia. In
pretubercular and early cases of pulmonary consumption, mullein
appears to have a distinct weight-increasing power; and I have
observed this in several private cases also. Having no weighings of
these latter, however, makes this statement merely an expression of
opinion. In early cases, mullein milk appears to act very much in
the same manner as cod-liver oil; and when we consider that it is
at once cheap and palatable it is certainly worth a trial. I will
continue the research by careful weighings of early cases; and will
further endeavor to ascertain whether the addition of mullein to
the cultivating solution prevents the propagation of the phthisical
bacillus.</p>
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