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Used as a decoction and tincture.

Black Haw is a uterine sedative and relaxant very similar to Cramp Bark, to which it is closely related. It is used for dysmenorrhoea, false labor pains as well as in threatened miscarriage. Its relaxant and sedative actions explain its power in reducing blood pressure in hypertension. It may be used as an anti-spasmodic in the treatment of asthma.

King's 1898 Dispensatory:

That it has a decided affinity for the female reproductive organs is well established. By Dr. D. L. Phares, of Mississippi, who brought the remedy forward, it was described as having nervine, antispasmodic, tonic, astringent, and diuretic properties. To these Prof. King adds alterative.

Decoctions of the drug were formerly used as a gargle in aphthae, as a wash in indolent ulcers, and in various ophthalmic disorders. By its astringency it has proved of value in diarrhoea and dysentery. It has been recommended in jaundice, but we have a better agent in chionanthus. Palpitation of the heart is said to have been relieved by it. Such cases are sympathetic disturbances, generally near the menstrual period.

Its principal use at the present day is in disorders of the female organs of reproduction. As a uterine tonic it is unquestionably of great utility. It restores normal innervation, improves the circulation, and corrects impaired nutrition of these organs. In the hyperaesthetic, or irritable condition of the uterus incident to highly nervous women, or as the result of overwork, it will be found an admirable agent. It is called for in weakened conditions of the body, with feeble performance of the uterine functions.

In dysmenorrhoea, with deficient menses, uterine colic, and in those cases where there are severe lumbar and bearing-down pains, it will prove an efficient drug. Helonias is also an excellent agent in the latter condition. It is specifically indicated in cramp-like menstrual pains—pains decidedly expulsive and intermittent in character and in the various painful contractions of the pelvic muscles, so common to disorders of women. Uterine congestion and chronic uterine inflammation are often greatly relieved by specific black haw. It acts promptly in spasmodic dysmenorrhoea, especially with excessive flow. Menorrhagia due to malaria is promptly met with Viburnum prunifolium. It is a good remedy for uterine hemorrhage, attending the menopause. In amenorrhoea in pale, bloodless subjects, the menses are restored by it. Cramps of limbs attending pregnancy yield to both black haw and cramp bark. It is considered almost specific for cramp in the legs, not dependent on pregnancy, especially when occurring at night.

The condition for which black haw is most valued is that of threatened abortion. It is the most prompt drug in the materia medica to check abortion, provided the membranes have not ruptured. In all cases of habitual abortion it should be given in small doses for a considerable length of time. The abundant testimony as to its value in this condition alone gives it a high place among drugs.

By its quieting effects upon the irritable womb, women who have previously been unable to go to full term have been aided by this drug to pass through the pregnancy without mishaps which would otherwise have proven disastrous to both child and mother. Small doses of the specific black haw should be administered throughout the dangerous period, and may be continued with good results until parturition. Dr. Phares, who introduced it as all antiabortive, states that it will prevent abortion, whether habitual or otherwise-whether threatened from accidental cause or criminal drugging. He considered it to completely neutralize the effect of the cotton bark when this is used for the purpose of causing abortion. It was for a long time customary for planters to compel their female slaves ''to drink an infusion of black haw daily whilst pregnant to prevent abortion, from taking the cottonroot'' (Scudder, Spec. Med., 266).

It has been used to control postpartum hemorrhage, but is less effective than ergot and cinnamon. It assists in reducing the size of the womb in subinvolution of that organ. Viburnum is of some value in nervous disorders, and has been advised in chorea, hysteria, hystero-epilepsy, petit mal, and paralysis agitans. It is of service only when these troubles are associated with menstrual wrongs. Viburnum Opulus resembles this agent very closely in its effects, and may be used in the above-named conditions, for which the black haw is useful.

American Materia Medica, 1919 (Ellingwood):

Physiological Action—Its influence is exercised upon the womb, regulating its function and soothing irritation. The agent has not had thorough study to determine its exact physiological action. It however exercises its influence through the nervous centers, soothing nerve irritation and possessing marked antispasmodic properties. It influences the motor side of the cord, producing progressive muscular weakness, loss of reflex action and ultimate paralysis. It apparently directly influences the action of the heart, as it lowers arterial pressure to a marked degree.

Its sedative influence upon the nervous system is conveyed to the uterus and appendages and there becomes apparent. It overcomes all forms of nervous irritation, and irregular functional action in these organs. It is the direct remedy for nervous conditions of the pregnant state.

Therapy—It is the remedy for dysmenorrhea, especially that characterized by cramp-like pains of spasmodic character. It promotes normal uterine contractions and antagonizes those of an irregular character. It is valuable in menorrhagia and metrorrhagia, either of an acute or a passive character. In all of these cases its use should be begun a few days in advance of the anticipated disorder and continued through and beyond the menstrual period.

Viburnum prunifolium is especially a uterine sedative in threatened miscarriage. It is particularly indicated in habitual abortion, preventing an anticipated occurrence and permanently overcoming the habit. I have had practical experience extending over thirty years, and have perfect confidence in the agent based on repeated success. In one of my cases it caused the womb to suspend expulsive action and to retain a dead fetus for months; given in large doses after the fourth month no return of the expulsive effort occurred until the seventh, when the agent was discontinued, after which a four-months mummified fetus was expelled without detriment to the health of the patient. She had decreased in size since the fourth month and there was no fetal movement. The agent, when there is no habit of abortion, will probably accomplish the desired result if begun after hemorrhage has continued some hours, if the membranes are not detached or the sac ruptured.

Doses of one dram of the fluid extract every hour are necessary until the pain subsides or the flow ceases. The patient must be kept in a recumbent position and perfectly quiet. It is safer to begin either preceding, or with the flow in these cases.

In habitual cases it is necessary to give the agent in occasional doses for one, two or more weeks preceding the time of the miscarriage, which usually occurs each time at the same month of the fetal life. As the time approaches the patient is kept. quiet and free from excitement, and the agent is given three or four times daily. The interval is shortened to one or two hours with the first suspicious indications at the usual time. If no symptoms appear the agent is continued beyond the period, and then perhaps in daily doses only for a week or two longer. The physician should advise the patient to remain constantly on the watch for indications suggesting the necessity of an increase in the doses. The agent will stop induced miscarriage, as well as other forms, if no injury has been done to the membranes.

In small doses, it is an excellent partus preparator, materially improving the conditions when irregular and distressing symptoms are present and greatly facilitating a speedy and uncomplicated normal labor. It controls after pains and prevents post-partum hemorrhage. It insures normal involution and assists in retaining a normal position of the womb subsequently, where malposition had previously existed.

In its influence in overcoming reflex nervous disturbances, it is often most efficient in controlling the morning sickness of pregnancy and the entire train of distressing symptoms present at this time. It changes the mental condition of the patient from that of depression and despondency, to one of cheerfulness and hopefulness.

There is probably no proprietary remedy advertised for female complaints, and for promiscuous use in cases of this character, that does not contain viburnum prunifolium as the basic remedy. Its field of usefulness is a wide one as far as the genito-urinary apparatus is concerned.

It is the remedy for sympathetic disturbances of the heart, stomach and nervous system, common to sensitive ladies with irritable nervous systems, preceding or during the menstrual epoch, depending on vasomotor derangement. It must be given in advance and continued through the period.

In a number of cases, when given for menstrual irregularities, or for the distress induced by uterine displacement, in previously sterile females, pregnancy has promptly occurred, proving the influence of the agent in restoring normal functional ovarian activity.

It must not be overlooked in the treatment of irregular sudden, menstrual flow, occurring during eruptive and low continued or violent inflammatory fevers, especially in young ladies. This occurrence is not uncommon in smallpox, scarlet fever, diphtheria, measles, pneumonitis, pleuritis, phthisis and typhoid fever. It is sometimes of serious import, and masked sepsis undoubtedly occurs in the cases, with severe peritonitis or metritis, to which the patient may succumb. With antiseptic douches and disinfectant measures, viburnum internally is the surest remedy known, in this condition. it s given in conjunction with other indicated remedies, and its use must be begun promptly upon the appearance of the flow.

Viburnum is well classed among the tonics, as there is usually a general improvement in all the body functions while it is taken which is usually permanent. It has a very satisfactory effect upon derangements of the stomach and intestinal tract, especially in females when the whole system is out of tone. It restores the nerve influence, improves the circulation, supplies nutrition to the womb and ovaries. It is valuable in dysmenorrhea which is due to debility.

It is mildly efficacious in irregular muscular movements, in chorea, especially if occurring from early menstrual derangement, and in some cases of paralysis agitans.

It is advised in hysteria, hystero-epilepsy, and petit mal, but its influence is mild. It will act in harmony with cimicifuga and passiflora and the bromides in these cases. It is an agent of great usefulness, and its field broadens with every practitioner, as his knowledge of its influence increases with practical experience in its use.