[Footnote: From a paper published in the _British Medical Journal_.]
By F.J.B. QUINLAN, M.D., M.R.I.A., F.K.Q.C P., Physician to St.
Vincent's Hospital, Dublin.
From time immemorial, the _Verbascum thapsus_, 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 _British Botany_, 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.
"There are five mulleins, all belonging to the parent order of the
Scrophulariaceæ; but the old Irish remedy is the great mullein, or
_Verbascum thapsus_, 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.
"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.
"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.
"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."
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 _pectorale_) 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.
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