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| Lobelia inflata |
Lob.
One of the most difficult mountains for people to climb is the one they make out of a molehill.
[McKenzie]
Signs
Lobelia inflata. Indian Tobacco. N.O. Lobeliaceae.
CLASSIFICATION With about 30 genera and 1,200 species, the cosmopolitan Lobelia family is especially common in the Americas and the tropics. “It is a medium-sized family with life forms ranging from tiny annuals to trees, often of weird habit. Species of the Hawaiian genus Cyanea resemble palms. Desert species of Lobelia and Monopsis have developed needle-like leaves and the Australian Lobelia gibbosa is succulent. Certain representatives of Clermontia are epiphytes and several Lobelia species are aquatic. … The Lobeliaceae is an advanced type of the Campanulaceae from which it differs in its irregular flowers, connate anthers and the present of different alkaloids. However, the relationships between the families are so close that some authorities include the Lobeliaceae as a subfamily of the Campanulaceae.”1
FEATURES The leaves are alternate, simple and without stipules. The flowers are irregular, mostly blue, red or violet, normally bisexual and are inverted on their axis through 180o. They are arranged in racemes or panicles lacking the terminal flower; single-flowered species are rare. Cross-fertilization is enhanced by a pollination method termed protandry: the male reproductive organs mature before those of the female, releasing the pollen from the anthers before the stigma in the same flower is receptive. In the Lobeliaceae the style pushes through the tube formed by the fused anthers and drives the pollen out at the top, where it is collected by insects. Pollen carriers include a variety of aphids, bees and butterflies; some large-flowered varieties are pollinated by birds. Many members of the family are strongly poisonous. For instance, Laurentia longiflora from South America supplies isotomin, a heart poison, and the mere smell of the Chilean L. tupa may cause poisoning. Lobelia inflata is the source of important alkaloids and yields a remedy for asthma and whooping cough. 2
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| Lobelia inflata |
GENUS The genus Lobelia is named after Matthias de l’Obel [1538-1616], the Flemish botanist and physician to James I. The genus comprises some 360 species of annual and perennial herbs, shrubs, and small trees with simple, alternate leaves and milky sap. The flowers are two-lipped with three large, spreading lower lobes and two smaller, recurved upper lobes. Many species are grown as ornamentals and are much valued for their long flowering-period. Homoeopathy employs six species of Lobelia. Lobelia cardinalis, Cardinal Flower, is a clump-forming perennial herb with scarlet flowers, native to the eastern parts of the USA. Lobelia dortmanna, Water Lobelia, is a perennial aquatic herb with mauve flowers, native to North America and West Europe. Lobelia erinus, Edging Lobelia, is a small perennial herb with purple flowers with a yellow or white throat; it is a native of South Africa, but has been in cultivation since the 17th century and is commonly used for bedding. Lobelia purpurascens is actually not a Lobelia species but a member of the closely related genus Pratia. Pratia purpurascens has pale purple flowers and very white roots and is widespread in damp places in all eastern states as well as in South Australia, where it has a reputation as being effective against snakebite. Lobelia syphilitica – Lobelia coerulia – is a clump-forming perennial herb with blue flowers, native to eastern parts of the USA where Indians used the roots of the plant to cure venereal diseases. The North American species Lobelia inflata is cultivated for its medicinal leaves.
LOBELIA INFLATA Lobelia inflata is a common plant in meadows, pastures and cultivated fields, as well as along roadsides and in woodland areas from eastern Canada to Georgia. It is a hairy plant of 30-80 cm high, with an erect stem, densely branched, and milky sap. It flowers in loose racemes; the pale blue corolla is tubular, irregular, two-lipped and five-lobed. The flowers are followed by small, inflated pods, about the size of a white bean, containing numerous very small seeds. Samuel Thomson, in New Guide to Health, compared the pod with the stomach: “This pod is an exact resemblance of the human stomach, having an inlet and on outlet higher than the middle; from the inlet it receives nourishment, and by the outlet discharges the seeds.”
TOBACCO Lobeline, the active alkaloid in L. inflata and some other lobelias, has a high affinity for nicotinic acetylcholine receptors and produces effects almost identical to those of nicotine. In toxic doses both cause emesis, and they cause cardiovascular effects through actions on the autonomic nervous system. Lobeline is found throughout the plant, including the seeds. Lobelia inflata was used ceremonially as a tobacco substitute by North American Crow Indians, while Mapuche Indians in Chile smoked the leaves of Lobelia tupa, known as tabaco del diablo, as an inebriant.
TOXICOLOGY Lobelia inflata is toxic; animals have been poisoned by feeding on the herbage, and people have died from overdoses of the herb in the treatment of laryngitis and spasmodic asthma. Lobeline acts by exciting, and then depressing, the central nervous system. Symptoms of intoxication include nausea, vomiting, prostration, dilation of pupils, stupor, coma, and finally, convulsions and death.
EFFECTS “The earliest effects are pain in back of head, with feeling of fulness, tightness, and giddiness; these are followed by general tremor, with prickling sensation throughout body, nausea, and profuse perspiration. Violent emesis, if not already present, soon ensues. The painfulness and giddiness in the head generally alternate with the nausea; and on the occurrence of profuse perspiration the head symptoms usually subside. Great prostration of strength and relaxation of the entire muscular system now set in, accompanied by heavy despondency and fear of death. There is much thirst; the hands and arms are thrown about, and the sufferer rubs or beats his stomach; the secretion of saliva and of mucus is increased; there is dryness, burning, and rawness in the throat, and frequent and difficult deglutition, with irritation of the oesophagus and oppression of praecordium. Extreme spasmodic difficulty of breathing attends these distressing conditions, and there is great flatulent distension throughout the abdomen, especially in the neighbourhood of the navel, with frequent eructations, and flatulent discharges from bowels. At same time urine is very profuse, and causes a smarting sensation along its passage. Most other secretions are likewise increased. … The senses are rendered more acute; the brain is generally excited; the mind wanders, sometimes lapsing even to wild and furious delirium, although a calm and placid sensation pervades the system generally. The evacuations are seldom increased in frequency. The patient mostly remains quite still, since to move causes return of the sudden and violent vomiting, with additional prostration. After a time he gets short periods of sleep, or sinks into a semi-somnolent condition, and out of one of these sleeps he awakes quite well.”3
MEDICINE Lobeline is an ingredient in several commercial products used to revive persons from drug overdoses. Lobelia leaves have been smoked as a psychoactive drug for their mildly euphoric, yet stimulating effects. 4 As a stimulant to the respiratory centre, lobeline was formerly claimed to be a powerful resuscitant in respiratory failure [from narcosis], collapse, or shock, after carbon monoxide poisoning, after acute morphine intoxication, and in asphyxia in newborn infants. Administration of the drug was intramuscular since oral administration was considered unreliable or ineffective. The use of the drug is now obsolete. Lobelia, however, is still an ingredient of some over-the-counter anti-smoking preparations and cough mixtures. The medicinal key actions of Lobelia are antispasmodic, expectorant, stimulant [respiratory], emetic, and diaphoretic. Applied externally, its antispasmodic action helps to relax muscles, particularly smooth muscle, which makes the herb useful for sprains, and back problems where muscle tension is a key factor. Chilean peasants employ the juice of L. tupa to relieve toothache.
THOMSON During the 18th and 19th centuries a largely dispossessed European population moved into the large tracts of North America for a new life in the ‘New World’. Often remote from anything resembling civilization, including medical service, settlers adopted Indian lore in formulating their home remedies. There were specialists, both women and men, who became well known for their ability to use herbs. As this was already an enterprise society, several of them took to the road, moving from one homestead or town to another, often peddling dubious nostrums, and setting up their ‘travelling medicine shows’. Several were quite proficient, but all were disparagingly lumped together as ‘white Indian doctors’. One of these ‘white Indian doctors’ was Samual Thomson [1769-1843], brought up on a farm in New Hampshire and introduced to herbs as a shepherd boy by a ‘wise woman’, Mrs Benton, who was versed in Indian lore. The major clinical condition facing Thomson and his contemporaries was infectious diseases, marked by fever. The ‘Regular’ approach was to see the high body temperature as a potentially very serious threat, something to be removed as efficiently as possible. By contrast, Thomson was pointing out the ancient vitalist herbal tradition to see fever as extraordinary vital activity, as an effort of the body to fend off the invasion of cold disease. Thomson followed the Indian technique of actually heating the body further in support of these efforts. At early and robust phases of fever his primary concern was to manage the process, to stop it getting out of hand. His most famous remedy here was Lobelia inflata, originally used as an emetic, ‘Indian pukeweed’, but in lower doses a notable relaxing remedy, which he found considerably reduced the spasms, convulsions and pains of many fevers and was incidentally an effective expectorant in bronchial infections. The system of medical practice which he patented in 1813 and then again in 1823 and sold throughout the country for a fee of twenty dollars per family was built around the liberal use of Lobelia or, as he liked to call it, ‘old No. 1. ‘ Proud of his lack of formal education, he wanted to seize medicine from what he considered the monopolistic hold of educated professionals and return it to the common people. He was the first person to publicly attack allopathy in America and his criticism of the follies of orthodox practice were often accurate and stinging. Thomson’s popularity and his outspoken attacks on the medical profession earned him their unbridled wrath. His detractor, Wooster Beach, called him ‘illiterate, conceited, arbitrary and selfish’, while one historian described him as ‘one of those illegitimate sons of Aesculapius, who have arisen from time to time to vex the souls of the regular profession.’ The name of Lobelia became so odious that to be known as a ‘Lobelia doctor’ was sufficient to subject the physician to all manner of ridicule. Thomson fought legal battles with the government, regular practitioners and other medical sectarians, but was also hounded through the courts and accused of manslaughter and murder. 5,6 According to Klaassen, in Casarett and Doull’s Toxicology, Thomson was charged with causing the death of some of his patients by administering Lobelia inflata in repeated doses. “[In 1809] he was imprisoned on the charge of murder by the use of Lobelia. … The case was brought to court, but the charges were shown to be fabricated, and he was released without being allowed to stage a defence. Despite these facts, the charges that Thomson killed a man with Lobelia was repeated for the next hundred years by almost every allopathic author on materia medica and many of the homoeopaths as well. At the same time, the use of Lobelia as an antispasmodic for the paroxysm of asthma was adopted by the allopathic profession, without giving Thomson credit for the discovery.”7
PROVINGS •• [1] Introduced and proved by Jeanes – 4 [male] provers, 1836; method: unknown.
•• [2] Noack – 5 provers [4 males, 1 female], 1839-40; method: repeated doses of tincture in increasing amounts.
•• [3] Barrallier – 11 [male] provers, 1864; method: 5-40 drops of tincture, manner not stated; observation period: one day.
[1-2] Heywood, Flowering Plants of the World. [3] Phillips, cited in Hughes, Cyclopaedia. [4] Kindscher, Medicinal Wild Plants of the Prairie. [5] Mills, The Essential Book of Herbal Medicine. [6] Boyle, Herb Doctors: Pioneers in 19th-Century American Botanical Medicine. [7] Wood, The Book of Herbal Wisdom.
Affinity
RESPIRATION. Vasomotor nerves. Secretions. Heart. Epigastrium.
Modalities
Worse: Cold bathing. Suppressions. Sleep, after. Tobacco. Touch. Slightest motion. Exertion. Going up or downstairs.
Better: Rapid motion [pain in chest]. Eating a little. Warmth.
Main symptoms
M Hypochondrical anxiety.
SMALL SYMPTOMS LEAD TO FEAR.
Hysteria, esp. globus hystericus.
Spasms of oesophagus; swallowing difficult.
• “Humans given intravenous microgram doses of lobeline experience sensations of choking and pressure in the throat and upper chest, and eventually a dry cough. Reflex changes in breathing occur shortly before the onset of the sensations.”1
M Psychogenetic dyspnoea; fear leads to dyspnoea.
Dyspnoea < thinking of it. [Hyperventilation!] G Chilly. G Tobacco [aversion + <]. Allergic reactions to tobacco. G > BEER.
G SPASMODIC AFFECTIONS.
G PRICKLING EXTERNALLY.
G RELAXATION and increased secretions, esp. COLD SWEAT, and weakness.
G Ailments and FAINT, gone feeling in STOMACH.
• “I have found it most useful in the dyspepsia due to excessive use of green tea, tobacco and bad liquor. In such patients you will always find the faintness at the stomach a prominent symptom.” [Hale]
G NAUSEA + constant SALIVATION + cold SWEAT + prostration + constrictive pains.
• “It never occurred to me that it [Lobelia inflata] was of any value as a medicine until, when moving in the field with a number of men one day, I cut a sprig of it and gave it to the man next to me, who ate it; when we had got to the end of the piece, which was about six rods, he said he believed that what I had given him would kill him, for he never felt so before in his life. I looked at him and saw that he was in a most profuse perspiration, being as wet all over as he could be; he trembled very much, and there was no more colour in him than in a corpse. I told him to go to the spring and drink some water. He attempted to go, and got as far as the wall, but was unable to get over it, and laid down on the ground and vomited several times. He said that he thought he had thrown off his stomach two quarts. I then helped him into the house, and in about two hours he ate a hearty dinner; in the afternoon he was able to do a good half-day’s labour. He afterwards told me that he never had anything do him so much good in his life; his appetite was remarkably good; he felt better than he had for a long time.”2
P Cold sweat on [pale] face during nausea and vomiting.
P SALIVATION as a concomitant of retching, hiccough, nausea, dyspnoea, etc.
P Nausea.
And Prickling itching of the skin [or sensation of thousands of needles].
• “I believe it will prove as useful in the vomiting from fright, and other emotions, in nervous subjects, as Gelsemium is in diarrhoea [involuntary generally] from similar causes.” [Hale]
P Sensation of excessive weakness in stomach.
Extending up into the chest and down to the umbilical region.
And Oppression of chest.
P Asthmatic attacks [spasmodic].
And Faint feeling in pit of stomach and prickling all over [or preceded by prickling].
[Compare hyperventilation!]
P Sensation as if heart would stand still. [Comp. hyperventilation]
[1] Spinella, The Psychopharmacology of Herbal Medicine. [2] Samuel Thomson, cited in Hale’s New Remedies.
Rubrics
Mind
Confusion, after eating [1]. Presentiment of death [1]. Dulness when spoken to [1]. Fastidious [1]. Fear, of heart disease [1], of suffocation [2]. Morphinism [1].
Vertigo
Alternating with nausea [1*].
Head
Pain, alternating with nausea [1*], > perspiration [1*], from smoking tobacco [2]; temples, extending from temple to temple [1].
Ear
Noises, sounds of cymbals and drums [1/1]. Stopped sensation > boring with finger [1].
Hearing
Impaired, after a suppressed discharge [1/1].
Stomach
Emptiness extending to chest [1*], to heart [3], to umbilical region [1*]. Eructations, after coughing [1], with sneezing [1]. Sensation of a lump [1]. Nausea, at night on waking [2], alternating with vertigo or headache [1*], > drinking [2], > after eating [2], with salivation [3], after sleep [2], after smoking [2].
Respiration
Difficult, in cold air [3], after warm food [2].
Chest
As if heart would cease to beat [3]. Sensation of weakness about heart [1].
Back
Pain, sore, sacral region, sensitive to touch of clothing [2].
Dreams
Amputation of arm [1]. Injuries [1]. Being wounded by a shot [1].
Generals
Knotted sensation internally [1]. Pains appear and disappear gradually [1]; stitching outward, extending to fingertips [2].
* Repertory additions [Hughes].
Food
Aversion: [2]: Tobacco; tobacco, smell of. [1]: Brandy.
Desire: [1]: Coffee; fat; sweets.
Worse: [2]: Alcohol. [1]: Cold water; pastry; tea; tobacco.
Better: [3]: Beer.