Claire’s Soothing Tonic for Margaret Campbell

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A Dram of Outlander
Voyager Read-along
Chapter 29:  Culloden’s Last Victim
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Once a Physician, Always a Physician

After spending her entire adult life as a healer, first as a combat nurse and then as surgeon, Claire soon finds herself once again doctoring in 18th century Scotland.

Claire’s discussion of herbs and remedies with the apothecary reveals her extensive knowledge, and overhearing this, Reverend Campbell asks Claire to recommend a remedy to help with his sister’s “nervous complaints.” Never one to refuse a person in need of help, Claire of course offers to visit Margaret Campbell to evaluate her for herself.

According to her caregiver, Margaret suffers from mysterious episodes of silently staring off into space for as long as nearly two weeks at a time, followed by screaming to exhaustion, and falling asleep, only to awake unaware of what has happened.  Claire finds Margaret in a state of silent staring, seemingly oblivious to her surroundings. However, aside from evidence of vitamin C deficiency and physical inactivity, her examination of Margaret reveals no significant physical ailments.

What Has Happened to Margaret Campbell?

Margaret’s symptoms began after she was brutally attacked by English soldiers. She had been searching for her beloved, Ewan Cameron, in the aftermath of the Battle of Culloden, when she fell into the hands of a group of English soldiers.  Margaret was attacked, raped, and left for dead.  Later reunited with her brother, she was never the same and spent the next 20 years alternating between a normal state of mind, a catatonic state of silently staring, unaware of her surroundings, and continual screaming.

The description of sitting, staring off into the distance, not speaking, and being seemingly unaware of the people around her is consistent with catatonic behavior. Once a diagnosis of its own, catatonia is now a descriptor of rare subtypes of other disorders such as schizophrenia, bipolar disorder, major depression and PTSD.  Margaret may be experiencing catatonic symptoms as part of a rare form of PTSD as a result of the trauma she sustained at the hands of the English soldiers. It is also possible that she developed schizophrenia and began to display symptoms at this time (the peak period for the onset of schizophrenia is late adolescence and early adulthood, and she would have been around 17 years old at the time of the attack).

How Can Margaret Be Helped?

Treatment options for catatonia include antipsychotic medications, benzodiazepines, electroconvulsive therapy as well as supportive therapy.  The physical inactivity and refusal to eat in catatonia can result in muscle contractures, pressure sores, blood clots, weight loss, dehydration, electrolyte disorders, and vitamin deficiencies.  Some patients will require IV fluids and tube feedings to provide adequate hydration and nutrition, as well as anticoagulants to avoid blood clots.

With the resources available to her, Claire suggests a “soothing tonic” for Margaret, containing chamomile, hops, rue, tansy, verbena, and peppermint.

Claire’s Soothing Tonic for Margaret Campbell

Chamomile
chamomile
AKA German Chamomile
Used for: flatulence, travel sickness, nasal mucous membrane inflammation, nervous diarrhea, GI spasms, inflammation of the GI tract, restlessness, insomnia
Used topically for: hemorrhoids, leg ulcers, mucous membrane inflammation
Interesting fact:  Chamomile is a member of the Asteraceae/Compositae family which includes ragweed, chrysanthemum, marigold and daisy.  As a result, people who are sensitive to these may these (especially ragweed!) by experience allergic reaction to chamomile!

Hops
hops
Used for: restlessness, anxiety, sleep disorders, tension, excitability, nervousness, irritability, indigestion, as an antibacterial, as an appetite stimulant.  Also has been used for dysentery, leprosy and pulmonary tuberculosis.
Interesting fact:  Hops comes from the family cannabinaceae (hemp, marijuana)

Rue
rue
AKA Herb-of-Grace, Garden Rue, Common Rue
Used for: menstrual disorders, loss of appetite, heart palpitations, nervousness, hysteria, fever, headaches, weakness of the eyes.  Has been used for Multiple Sclerosis, Bell’s Palsy and cancers of the mouth.
Used topically for: skin inflammation, earaches and toothaches, as well as arthritis and sprains.  Has been used as an insect repellant.
Interesting fact: used as a bitter flavoring for food and beverages and as a fragrance in soap and cosmetics

Tansy
tansy
AKA Bitter Buttons, Daisy, Tansy Flower, Parsley Fern, Stinking Willie
Used for: regulating menstrual flow, treating roundworm infestation, migraines, neuralgia, epilepsy, rheumatism, stimulating appetite, flatulence and bloating, stomach ulcers, calming nerves, hysteria
Used topically for: scabies, bruises, sprains, sunburn, toothache and as an insect repellant
Interesting fact:  Thujone, a component of tansy, is thought to have a mind-altering effect similar to THC (the active component of marijuana).  It can be toxic to the nervous system and liver and can lead to seizures.

Verbena
verbena
AKA Pigeon’s Grass, Pigeonweed, Herb of Grace, Herb of the Cross, Juno’s Tears
Used for: sore throat, respiratory diseases like asthma and whooping cough, depression, hysteria, seizures, melancholia.
Used topically for: poorly healing wounds, burns
Interesting fact: used as a flavoring agent in alcoholic beverages

Peppermint
peppermint
AKA Brandy Mint, Lamb Mint
Used for: loss of appetite, spasms of the GI tract, flatulence, gastritis, enteritis, nausea and vomiting, morning sickness and soothing for cough and colds
Interesting fact: common culinary spice in foods and herbal teas

Benzodiazepines are one of the main treatments for catatonia today.  They are thought to have their action by binding to GABA receptors in the brain and increasing the efficiency of GABA in the brain.  Interestingly, chamomile also binds GABA and its sedative effects may be due to the same mechanism! Along with the sedating and calming effects of the other components of this soothing tonic, Margaret may well have some improvement in her symptoms.

 

Scurvy : The Ever-Present Scourge

scorbutic-gums

Margaret is also suffering from scurvy, as evidenced by her bleeding, spongy gums. Once the Campbells reach the West Indies, citrus fruits will be plentiful and will satisfy this need, but for now, Claire prescribes a tea of Rose Hips to provide vitamin C to reverse Margaret’s symptoms of scurvy.

Rose Hips
rose-hips
AKA Dog Rose, Hip Fruit, Hip Sweet, Hipberry, Wild Boar Fruit
Used for:  supplemental source of dietary vitamin C
Contains 1250mg of vitamin C per 100g of rose hip, making it one of the richest plant sources of vitamin C!
Interesting fact: itching powder (often used by pranksters to cause dreadful itching to their victims) is made from the fine hairs inside rose hips!

Check out the post It’s Green, Major, all about scurvy and Claire’s affinity for all things green!

All photos: Wikipedia Commons

 

References:

1. Sienaert, P., Dhossche, D. M., Vancampfort, D., Hert, M. D., & Gazdag, G. (2014). A Clinical Review of the Treatment of Catatonia. Frontiers in Psychiatry Front. Psychiatry, 5. doi:10.3389/fpsyt.2014.00181
2.  Jellin, J. M. (2003). Natural medicines comprehensive database. Stockton, CA: Therapeutic Research Faculty.
3. Srivastava, J., Shankar, E., & Gupta, S. (2010, November 1). Chamomile: A herbal medicine of the past with a bright future (Review). Molecular Medicine Reports, 3(6), 895-901. doi:10.3892/mmr.2010.377
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202: Master Raymond’s Apothecary: Catnip and Crocodiles

202: Not in Scotland Anymore

202 titlecard
STARZ

There are a few interesting medical discussions to be had in this episode but we’ve got to start with the amazing Master Raymond!

We are introduced to the much loved Master Raymond and his amazing apothecary.  I do hope we see more of this amazing space.

apothecary interior with crocodile
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He is exactly as expected from Claire’s description:

For Master Raymond resembled nothing so much as a large, genial frog.  A touch over four feet tall, barrel-chested and bandy-legged, he had the thick, clammy skin of a swamp dweller, and slightly bulbous, friendly black eyes.  Aside from the minor fact that he wasn’t green, all he lacked was warts.

From Dragonfly in Amber by Diana Gabaldon

 

master raymond
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Jamie suffers from terrifying nightmares as he works through healing from his experiences at Wentworth. Claire has sought out Master Raymond in hopes of obtaining something to help him sleep.

Claire initially requests Nepeta cataria, which is actually catnip!

800px-Catnip_flowers
Nepeta cataria / source

The flowering tops of catnip are medicinal and known to have calming effects on humans.  It has been used for insomnia, anxiety, gastrointestinal ailments and migraine headaches.  Catnip is famous for the euphoric state it induces in cats, though some question whether this same effect occurs in humans.

Instead, Master Raymond suggests an alternative: Valeriana officinalis combined with a touch of Humulus lupulus.  I suspect he has chosen a more potent medicine for Jamie.

got em
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Known as “herbal Valium,” due to its ability to calm the central nervous system and relax muscles, valerian root acts in a similar fashion to benzodiazepines like Valium and Ativan. These enhance the effect of the neurotransmitter GABA in the brain, resulting in sedative, hypnotic (sleep-inducing) and anxiolytic (anti-anxiety) effects.  Claire, of course, is familiar with valerian root as this is the same herb she used at The Gathering to sedate Angus and Rupert so she could attempt escape from Leoch!

628px-Valeriana_officinalis
Valeriana officinalis / source

Master Raymond has combined the valerian root with Humulus lupulus, or common hops.

Humulus
Humulus lupulus / source

Hops is a species of flowering plant in the Cannabaceae family, along with Cannibis.  In addition to its use in most beers, when taken orally, the dried fruiting part of the plant provides sedative and hypnotic effects.  Indeed, Master Raymond knows his business!

What about Master Raymond’s “Sang de Crocodile” (crocodile blood)?  While his was not true crocodile blood and was used more for impressing the French nobility, perhaps by claiming to enhance virility, freeze-dried crocodile blood capsules are sold in Asia today as a supplement.  Supporters of it claim it increases hemoglobin levels in rats and is advertised as a supplement for patients with anemia.

sang de crocodile
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More interesting though is the fact that crocodile blood actually holds promise for the development of medications to fight antibiotic-resistant bacteria!

Crocodiles sustain significant wounds in the course of hunting and killing prey and in fights with each other for territory, food and mating rights, but as scientists noted, despite these significant wounds, the crocodiles return to their habitat of bacterial laden swamp water and never seem to become ill from wound infections.  Researchers took samples of crocodile blood and exposed it to 23 different strains of bacteria, including antibiotic-resistant MRSA.  It turns out that while human blood could only kill off 8 of these strains, the crocodile blood killed ALL of the samples of bacteria!   Further tests showed it was also effective at killing HIV!  The potential application of this in developing antibiotics is pretty amazing.

800px-Crocodile_at_Auckland_Zoo_-_Flickr_-_111_Emergency
source

That Master Raymond is a man ahead of his time.  Or before it?  Hmm…

 

Further Reading:

BBC News – Crocodile Blood Antibiotics Hope 19 August 2005