Commercial. - Sound ipecac in quality is proportionate to the thickness of the bark (75-90 p. c), and the thinness of the wood (10-25 p. a), as most of the alkaloids reside in the former; that with very thick bark is designated as "bold" (fancy), that with thick woody centre as "wiry;" the stem portion should not indicate having been leaf-bearing, as such parts exposed to light and air are always weaker in alkaloids. Ipecac was known first in Europe, 1762, as about this time Helvetius, a Dutch physician, became celebrated in Paris from its secret use; it was, however, in 1688, purchased from him by Louis XIV. for 1,000 louis d'or ($4,600). It grows in rich loam of hot, moist forests, under trees in bunches, presenting two varieties according to its woody or herbaceous stems, the latter usually prostrate and covered with vegetable debris, otherwise exactly alike. This growth-habit produces a great distinction between the upper and lower stem-portions, causing the latter to be collected often with the root, when the product is termed "stemmy." The color of the roots of either kind is not uniform, both furnishing brown, red, and gray, which difference is only superficial, depending solely upon season of year collected, age, soil, climate, and mode of curing; the brown is least bitter and most abundant with us; the gray is most bitter and the larger. The root is collected at any time when the ground is soft (mainly Jan.-March), except in rainy weather, as then cannot dry properly, by poayeros (collectors, fr. poaya, Braz. name of the plant), who catch the stem, pull it backward as far as possible, and thrust deep into the ground a stick with broad, sharp end, thus cutting the ramifications, but leaving sufficient roots to produce, from adventitious buds, new plants the following year. The plant-juice is so irritating as rubiaceae to produce sores upon the hands and elsewhere, consequently collectors only accept such labor in the absence of rubber-gathering, and that otherwise more congenial, thus accounting largely for the drug's high price. Roots are freed from adhering earth by shaking, put into bags, at night assorted, next day spread in the sun and carefully dried 3-4 days, being protected at night from heavy dews, then broken into small pieces, separated from any remaining earthy particles by sieves, and packed tightly in bags or hide-bound bales (seroons), which are stored

Fig. 372.   Cephaelis Ipecacuanha.

Fig. 372. - Cephaelis Ipecacuanha.

Fig. 373.   Ipecac root; normal size.

Fig. 373. - Ipecac root; normal size.

carelessly a waiting sale - a condition, along with the incident exposure to damp weather and river-water in shipment, that renders three-fourths of the output considerably damaged by moldiness. There are two varieties: 1, Rio, Brazilian, Para (C. Ipecacuanha), distributed widely through Brazil, Bolivia, being collected chiefly in proximity to the Itenez River, and exported via Rio Janeiro or Para; 2, Cartha-gena, Columbian (C. acuminata), grown wild mostly in Columbia, being exported chiefly via Carthagena; contains an equal amount of total alkaloids, but more cephaeline and less emetine than Rio.

Constituents. - Alkaloids 2.28-3.36 p. c: Emetine 2-3.14 p. c, Cephaeline .6 p. c, psychotrine, ipecacuanhic acid (ipecacuanhin)

2.25 p. c, Kryptonine, C29H40N2O9 (colloidal), choline, resin, starch 40 p. c, wax, fat, volatile oil, erythrocephaelin (coloring matter - deep purple with alkalies), saccharose, ash 1.8-4.5 p. c.

Emetine (Methyl-cephaeline), C15H22NO2. - Obtained by adding basic lead acetate to alcoholic tincture, filtering, removing excess of lead with diluted sulphuric acid, neutralizing filtrate, distilling off alcohol, shaking out clear residual liquid with ether and ammonia, shaking out ether solution with weak sulphuric acid, and shaking repeatedly this acidulated solution with sodium hydroxide, in the presence of ether, until cephaeline (base soluble in caustic alkali) is separated completely; emetine (base insoluble in caustic alkali) is converted into hydrochloride, recrystallized from water, and finally precipitated with ammonia. It is amorphous, white, becoming yellow by exposure, soluble in alcohol, ether, benzene, chloroform; forms salts, most of which are crystalline. Dose, expectorant, gr. 1/200-1/60 (.0005 .001 Gm.); emetic, gr. 1/16-1/4 (.004-016 Gm.). Poisonous in large quantities; impure emetine is 10 times weaker.

Emetinae Hydrochloridum, Emetine Hydrochloride, C30H44N2O4.-2HC1, official. - (Syn., Emet. Hydrochl.; Fr. Chlorhydrate de Emetine; Ger. Emetinhydrochlorid, Salzsaures Emetin.) This hydrochloride of the alkaloid is obtained by dissolving emetine in diluted hydrochloric acid, allowing to crystallize. It is a white, very slightly yellowish crystalline, odorless powder, darker on exposure to light, soluble in water, alcohol; aqueous solution (1 in 20) slightly acid; contains variable amounts of water of crystallization. Tests: 1. Aqueous solution (1 in 100), + iodine T. S., mercuric potassium iodide T. S., or platinic chloride T. S. - precipitates. 2. With sulphuric acid containing in each Ml. (Cc.) about .005 Gm. of molybdic acid - bright green. 3. Aqueous solution, + silver nitrate T. S. - white precipitate, insoluble in nitric acid; dry at constant weight - loses 19 p. c.; incinerate .2 Gm. - ash non-weighable. Impurities: Cephaeline, readily carboniz-able substances. Should be kept dark, in dark amber-colored vials. Dose, expectorant, gr. 1/12-1/6 (.005-.01 Gm.); emetic, gr. 1/6-1/3 (.01-02 Gm.).

Cephaeline, C14H20NO2. - This is 2-5 times stronger than emetine, the two representing the drug's activity, and relative proportion varying; it is crystalline, white, becoming yellow by exposure, distinguished from emetine by its solubility in caustic alkalies and by being less soluble in ether; forms uncrystallizable salts. Dose, same as emetine.

Psychotrine. - This exists in ipecacuanha in small amount compared with two preceding alkaloids, and unlike them is only slightly soluble in ether; obtained by extracting with chloroform the ammoniacal liquid, from which emetine and cephaeline have been separated by ether; occurs in crystals which separate from ether in lemon-yellow transparent prisms, melts at 138° C. (281 ° F.), soluble in alcohol, chloroform.

Ipecacuanhic Acid (Cephaelic Acid), C14H18O7. - An amorphous, bitter glucoside, once believed identical with gallic acid, but more closely resembles caffeo-tannic acid; obtained by precipitating decoction with lead acetate, dissolving precipitate in acetic acid, then precipitating with lead subacetate; it is hitter, amorphous, brown, soluble in alcohol, green with ferric salts.

Preparations. - 1. Fluidextractum Ipecacuanha. Fluidextract of Ipecac. (Syn., Fldext. Ipecac, Fluid Extract of Ipecac; Br. Extractum Ipecacuanhae Liquidum; Fr. Extrait fluide d'Ipecacuanha; Ger. Ipecacuanhafluidextrakt.)

Manufacture: Similar to Fluidextractum Ergotoe, page 60; 1st menstruum: alcohol 20 Ml. (Cc.), water 20, diluted hydrochloric acid 10; 2nd menstruum: 40 p. c. alcohol; reserve first 80 Ml. (Cc), in which dissolve soft extract, assay and add enough 2nd menstruum for the 100 Ml. (Cc.) to contain 1.8-2.2 - 2 Gm. of ether-soluble alkaloids. Dose, ej-20 (.06-1.3 Ml (Cc.)).

Prep.: 1. Syrupus Ipecacuanha. Syrup of Ipecac. (Syn., Syr. Ipecac; Fr. Sirop d'Ipecacuanha; Ger. Brechwurzelsirup, Ipecacuanhasirup.) Manufacture: 7 p. c Mix, by thoroughly shaking, fluidextract of ipecac 7 Ml. (Cc.), water 30 Ml. (Cc.), acetic acid 1 Ml. (Cc.), set aside for 24 hours, filter, pass through filter water q. s. 45 Ml. (Cc.), add glycerin 10 Ml. (Cc.), sugar 70 Gm., water q. s. 100 Ml. (Cc.), mix thoroughly, strain. Dose, expectorant, ev-15 (.3-1 Ml. (Cc.)); emetic, 3ss-4 (2-15 Ml. (Cc.)). 2. Pulvis Ipecacuanha et Opii. Powder of Ipecac and Opium. (Syn., Pulv. Ipecac. et Opii., Compound Powder of Ipecac, Dover's Powder; Br. Pulvis Ipecacuanhae Compositus; Fr. Poudre d'Ipecacuanha opiacee - de Dover; Ger. Pulvis Ipecacuanhae opiatus, Doversches Pulver, Pulvis Doveri.)

Manufacture: 10 p. c Triturate together ipecac 10 Gm., powdered opium 10 Gm., sugar of milk 80 Gm.; reduce to fine uniform powder. It is grayish-white, light brown; microscopically - angular, cone-shaped fragments, slowly soluble in water or hydrated chloral T. S., strongly polarizing light with display of colors (sugar of milk), few tracheids, numerous starch grains of ipecac, .003-.017 Mm. (1/8325-1/1475') broad, few stone cells of opium (poppy) capsules. Dose, gr. 5-10 (.3-.6 Gm.).

Unoff. Preps.: Decoction, Infusion, each 5 p. c, dose, ℥ss-l (15-30 Ml. (Cc.)). Extract, dose, gr. 1/20-1/2 (.003-03 Gm.). Piluloe Anti-dyspeptic®, 1/10 gr. (.006 Gm.). Piluloe Laxativoe Compositoe, 1/16 gr. (.004 Gm.). Piluloe Laxativoe Post Partum, 1/13 gr. (.005 Gm.). Pilula Ipecacuanha cum Scilla (Br.) - ipecac 6, opium 6, potassium sulphate 48, squill 20, ammoniacum 20, syrup of glucose q. s. for mass, dose, gr. 4-8 (.26-5 Gm.). Syrup of Ipecac and Opium, tinct. ipecac and opium 8.5 p. c, spirit of cinnamon .4, cinnamon water 3.2, syrup q. s. 100. Tincture, 10 p. c Tincture of Ipecac and Opium, each 10 p. c (+ dil. alc), dose, oev-20 (.3-1.3 Ml. (Cc.)). Wine, 10 p. c, dose, ej-60 (.06-4 Ml. (Cc.)). Troches, each 1/3 gr. (.02 Gm.).

Properties. - Emetic, nauseant, expectorant, diaphoretic, sternutatory (cholagogue, antiseptic, haemostatic, counter-irritant). Small doses (gr. 1/8-1/4; .008-.016 Gm.), stomachic, tonic, large doses (gr. 5-20; .3-1.3 Gm.), emetic in 30 minutes, not violent nor depressing; if doses repeated, have tolerance, catharsis; may cause irritation, hemorrhage. Emetine kills animals by cardiac paralysis. Vomiting due to local irritation of the stomach and a direct action upon vomiting centre in the medulla; it increases, by stimulation, the secretion of bile, bronchial and intestinal mucus.

Uses. - Acute indigestion, nauseating bilious headache, small doses for bronchitis, whooping-cough, asthmatic catarrh, spasmodic croup (here syrup given until vomiting occurs), spasmodic asthma, pneumonia, rigidity of os uteri, haemoptysis, hemorrhage, atonic dyspepsia, vomiting in pregnancy (hourly ej; -06 Ml. (Cc.) of wine), catarrhal jaundice (gr. 20; 1.3 Gm. daily), pyorrhoea (fldext., alcresta), chronic

Fig. 374.   Undulated ipecacuanha.

Fig. 374. - Undulated ipecacuanha.

Fig. 375.   Striated ipecacuanha.

Fig. 375. - Striated ipecacuanha.

dysentery, diarrhoea, hectic sweats, cholera, cholera morbus, remittent fever, urticaria, cases of poisoning; locally in ophthalmia (decoction). As diaphoretic and expectorant give at long intervals; the syrup always to infants. Its action is somewhat irregular, gr. 5 (.3 Gm.) sometimes being as effective as gr. 15 (1 Gm.). Emetine gr. 1/10 (.006 Gm.) has induced vomiting, while gr. 12 (.8 Gm.) given in 24 hours have caused no unpleasant symptoms.

Poisoning: Usually have severe vomiting of stomach contents, mucus, blood, etc. Unless thoroughly vomited, wash out stomach with tannin solution, if necessary follow with opium, belladonna, cardiac stimulants.

Incompatibles: Lead and mercury salts, vegetable acids, astringent infusions, bismuth compounds, phenol and hydrocyanic acid.

Synergists: Emetics, sedative expectorants, warm drinks.