Aloes.

Other tomes: King's

In its influence upon the intestinal tract this remedy has long been considered an important one.

Many of our own physicians use it in sluggish conditions of the bowels. Its influence when properly guarded is different from that of any other laxative remedy, and in some cases is superior.

Our writers have not paid sufficient attention to it. Because it is one of the older remedies, it should not be discarded, but its exact place in our therapeutics should be determined. The aloe plant grows in the tropics in the East Indies and tropical islands. For several years it has been cultivated in the West Indies.

The older works describe it as tonic, purgative, emmenagogue and anthelmintic. Because of its unpleasant taste and irritating properties, its tonic influence is seldom utilized. In sufficient dosage it is a powerful purgative. This principle is thought to be present principally in an active derivative called emodin. But this principle and another derivative called aloin are less reliable in their effects than the total aloes properly purified.

A writer in the Journal of the A. M. A. claims that this remedy stimulates the activities of the muscular coat of the intestinal tract, increasing peristalsis principally of the large intestine. The movements that aloes causes are soft and dark colored and, ordinarily, not watery. Aloes seems to have a predilection for irritating or congesting the rectum and causes congestion generally of the pelvic organs, therefore, it is inadvisable to use aloes as a laxative when there are hemorrhoids, rectal or colon irritation or inflammation of the pelvic organs, or in pregnancy.

Its stimulant action to the mucous membranes of the intestines, probably reflex, increases the secretion of the liver and pancreas and the intestinal glands. The griping caused by aloes is referred to the umbilical region.

The most important therapeutic use for which it is recommended is as a laxative. On account of its especial action on the mucous membrane of the intestines, it causes a griping and congestion which necessitates combining it with other drugs that correct the unpleasant action, such as belladonna, colocynth and hyoscyamus.

Among the diseases for which this remedy is administered by the old school, and advised by their leading authorities, is simple jaundice with lack of tone; constipation depending upon weakness of the intestinal tract; amenorrhea with deficient capillary circulation, in which case it stimulates the circulation in the capillaries of the pelvic organs, and determines an afflux of blood to the uterine system. This is accomplished, only, however, in doses that are apt to be toxic, producing other pathological conditions.

It is used, also, in the treatment of hemorrhoids, due to a sluggish condition of the circulation of the inferior hemorrhoidal veins. Where this remedy is used for constipation, the indications are, plainly, deficient peristaltic action; the tongue is coated; the breath is foul; the abdomen is full and tumid; and there is more or less inclination to impaction of the colon.

The homeopaths have a very definite line of indications, among which are the following, which are taken from a paper in The Medical Century: Headache across the forehead, with heaviness of the eyes and nausea; incapacity for mental work; gastro-intestinal irritation, with coldness of the lower limbs from afflux of blood to the cerebral centers; bitter, sour, metallic taste; tongue coated yellowish white, stiff, dry and red; aversion to meat; thirst with dryness of mouth; eructations bitter, acid or sour; heaviness in the hepatic region; pulsation in the region of the naval; distention of the abdomen, especially with flatus.

Constipation of hypochondriasis and melancholia is best overcome by aloes. The homeopathic indications for the use of the drug in mental derangements are anxiety; patient is ill-humored, hates people and repels everybody; vertigo, etc.

Menorrhagia occurring in debilitated and relaxed subjects. The symptoms attending a case of this variety which would call for aloes, homeopathically prescribed, are fullness and heaviness in uterine region, with labor-like pains in loins and groin, worse on standing; menses too early and too profuse. Barker advocated the use of aloes in non-puerperal hemorrhoids; but says the local condition must be suitable for the use, or the disease will be aggravated; that is, a sluggish state of the circulation in the hemorrhoidal veins.

The recommendations for the use of aloes in hemorrhoids are practically homeopathic for its use. Some of its characteristic symptoms and indications in hemorrhoids, or in any other disturbance of that portion of the alimentary canal, are, heat and soreness in the rectum; urging to stool, especially in the morning; hemorrhoids protruding like grapes, with constant bearing down in the rectum; weakness or loss of power of the sphincter ani; itching and burning in the anus, etc. .

The comparison shows that Barker recognizes the possibility of an aggravation if the indications are not present, for this use of this especial drug. His indications include many of the homeopathic indications. The latter shows a much more exhaustive study which the experience of a hundred years has proven valuable.

Barker again advocates the use of aloes when hemorrhoids are associated with an irritable rectum, accompanied by frequent, teasing, thin evacuations, but gives a much smaller dose, In these conditions, Bartholow says it is generally better to give aloes by itself and in small doses.

When the drug is used in doses sufficient to get the active effects desired in the above conditions, other drugs are used in combination to overcome the unpleasant and even injurious or poisonous effects, as the following prescriptions will illustrate:

Aloes socc., ext. opii aq., sapo. cast, 10 grains each. Mix, ft., pil. No. xx. Sig. One pill morning and evening.

This prescription is used for hemorrhoids associated with an irritable rectum. The so-called officinal pill contains asafoetida, to diminish the drastic effects, while it increases the efficiency of the purgative action.

On the other hand, experience has taught that, although contra-indicated when there is congestion of the pelvic viscera and the existence of hemorrhoids, or when the hemorrhoids are associated with an irritable rectum and with frequent small, teasing, thin evacuations, aloes in small doses is a very efficient remedy.

Ellingwood's Therapeutist, Vol. 3, 1909, was edited by Finley Ellingwood M.D.