Calumbae Radix - Calumba Root. - The root, cut transversely and dried, of Jateorrhiza Calumba and Miersii. From the forests of eastern Africa, between Ibo and the Zambesi.

Characters. - Slices, flat, circular, or oval, about two inches in diameter, and from two to four lines thick, softer and thinner towards the centre, greyish-yellow, bitter. A decoction, when cold, is blackened by the solution of iodine.

Composition. - Calumba contains a non-nitrogenous, bitter principle, calumbin, C21H12O7, crystallising in white needles; an alkaloid, birberin, C20H17NO4; calumbic acid, C21H11O7; 33 per cent. of starch; but no tannin.

Dose. - 5 to 20 gr.

Preparations.

1. Extractum Calumbae

Extractum Calumbae. Aqueous. 8 in 1. Dose, 2 to 10 gr.

2. Infusum Calumbae

Infusum Calumbae. 1 in 20 of cold water. Dose, 1 to 2 fl.oz.

3. Tinctura Calumbae

Tinctura Calumbae. 1 in 8. Dose, 1/2 to 2 fl.dr.

Calumba is also an ingredient of Mistura Ferri Aromatica.

Action And Uses

Calumba is the first of the large and important group of hitter substances or bitters, which we meet with in the materia medica, and will therefore he fully discussed as the type of this class of remedies. Under the head of the other bitters, such as quassia and gentian, fresh description of their action and uses will be unnecessary, and reference will simply be made to the present account. So with the action and uses, at bitters, of the alkaloids (strychnia, quinia, etc.), and the aromatic bitters, including orange, lemon, cascarilla, etc.

1. Immediate Local Action And Uses

Externally. - Calumba and other bitters are antiseptic and disinfectant to a degree, arresting decomposition and fermenta-tion. They are not used for this purpose.

Internally. - Taken into the mouth, bitters, as their name implies, stimulate the nerves of taste, and thus induce several general reflex effects, of the first importance in digestion. (1) The saliva is increased, and therewith its solvent and digestive influence on the food in the mouth, as well as its stimulant action on the gastric secretion; (2) The vessels and glands of the stomach are excited through the central nervous system, and the gastric secretion is thus increased in a second way; an effect which is heightened if the bitter be aromatic, and relish given by the pleasant flavour.

Reaching the stomach, calumba and other bitters stimulate digestion in a third way, by acting upon the gastric nerves and causing a sensation closely resembling hunger. This rouses the appetite, and if food be taken within a few minutes, the other effects just described afford the means of digesting it. As in the mouth, the action of bitters in the stomach is greatly assisted by aromatics (essential oils) and alcohol (contained in tinctures). Like these substances, bitters also stimulate the local circulation, and produce a remote effect on the heart and systemic vessels, raising the blood pressure, and thus acting as "general tonics." They will also exert a certain controlling effect on any decomposition or fermentation which may be set up in the stomach. When given in excess, or for a long time, bitters will manifestly, for every reason, tend to irritate the stomach and induce indigestion.

Calumba and bitters in general pass slowly along the intestines, moderating decomposition, and slightly stimulating peristalsis when they contain tannin, which many of them do. They are not cholagogue.

The uses of calumba and other bitters internally depend on the actions just described. They are of great value as stomachics, and much employed in rousing gastric digestion in atonic dyspepsia, where the appetite and the ability to digest have been diminished or lost, as in anaemia, convalescence from acute diseases, in persons exhausted by over-work, whether mental or bodily, and in the subjects of chronic constitutional diseases, such as phthisis and syphilis. In such cases, bitter infusions form the best vehicle for acid or alkaline stomachics, as the case may require, combined with an aromatic tincture, which renders the mixture much more agreeable and active. Their use must not be continued too long without intermission; they must not be given in too concentrated a form; and they must be employed with caution, or entirely avoided, in cases of dyspepsia attended by much pain, vomiting, mucous secre-tion, as well as in organic disease of the stomach. Calumba is one of the least irritant of all bitter stomachics.

The action of bitters on the bowels no doubt adds to their value in indigestion, as they remove flatulence and promote evacuation. Some forms of diarrhoea are relieved by calumba. Whether given by the mouth or as enema, bitter infusions are anthelmintic, preventing and destroying the thread-worm.

2. Action On The Blood, Specific Action, And Remote Local Action

Whether bitters possess any direct action on the blood or tissues beyond those just described, is uncertain. The indirect effect on the system is manifestly great and of the first importance therapeutically, as they are the means of intro-ducing into the blood an increased amount of nutrient mate-rial. In this way bitters are tonics, invigorating the body whilst they increase appetite; a system of treatment which is agreeable and striking to invalids and persons enfeebled by disease, over-work, or dyspepsia.

Psireirae Radix - Pareira Root. - The dried root of Cissampelos Pareira. Brazil.

Characters. - Cylindrical oval or compressed pieces, entire or split longitudinally, half an inch to four inches in diameter, and four inches to four feet in length. Bark greyish-brown, longitudinally wrinkled, crossed transversely by annular elevations; interior woody, yellowish-grey. porous, with well-marked often incomplete concentric rings and medullary rays. Taste at first sweetish and aromatic, afterwards intensely bitter.

Composition. - Pareira root contains, amongst other ingredients, an active principle, pelosin, believed to be identical with beberia.

Incompatibles. - Persalts of iron, salts of lead, and tincture of iodine.

Preparations.

1. Decoctum Pareirae

Decoctum Pareirae. 1 in 13 1/3. Dose, 1 to 2 fl.oz.

2. Extractum Pareirae

Extractum Pareirae. Aqueous. 16 in 1. Dose, 10 to 20 gr.

3. Extractum Pareirae Liquidum

Extractum Pareirae Liquidum. 1 in 1. Dose, 1/2 to 2 fl.dr.

Action And Uses

The physiological action of Pareira is imperfectly known, but it is believed to possess mild bitter and laxative effects, and to be a moderately active diuretic.

Empirically, it is used in inflammatory affections of the urinary tract, from the pelvis of the kidney downwards, being held to relieve pain, reduce irritation, and promote healing and cessation of muco-purulent discharge. The extract is given along with the decoction to increase its strength; not alone.

Cocculus Indicus. (Not Officinal.) - The fruit of Menispermum cocculus. the Cocculus indicus plant. From the East Indies.

Characters. - A small dark brown berry containing a yellowish reniform seed.

Composition. - The active principle of cocculus is a bitter neutral substance, picrotoxiner C9H10O4, in colourless crystals, neutral, soluble with difficulty in water. It is united with nunispermic or cocculinic avid, and other principles.

Dose of Picrotoxin. - 1/120 to 1/20 gr.

Action And Uses

Externally, cocculus or picrotoxin, in the form of a dilute ointment, very carefully applied to the unbroken surface, destroys pediculi.

Internally, picrotoxin is a very powerful agent, especially stimulating the spinal cord and medulla, and causing violent spasms of the flexors, and intoxication in large doses. It has been chiefly used in the night-sweating of phthisis, and in chronic nervous diseases.