Pepsine or Pepsin. The digestive principle obtained from the stomach of the hog, sheep, or calf.
There are two varieties of Pepsine used in medical practice. One is obtained by digesting the mucous membrane of the stomach of the calf or sheep, with its secretion, in distilled water, and precipitating the Pepsine by means of Acetate of Lead. The lead is then removed by Sulphuretted Hydrogen, which leaves the Pepsine in solution. The solution is acidified with lactic Acid, and evaporated to a gum-like mass, which is then mixed with dried starch. The other variety is made from the stomach of the hog, and was introduced by Dr. Lionel Beale under the name of Pepsina Porci The lead process is not employed in its preparation. It is said to be five times stronger than the former preparation. Pepsine prepared from the stomach of the sheep or calf, and mixed with starch, occurs as a greyish white powder, having an acid and somewhat unpleasant odour. Beale's Pepsina Porci prepared by Bullock is of somewhat darker colour, free from acid, and has an odour like that of burnt flour. Pepsine, independently of starch, is soluble in water. Its watery solution, acidulated with lactic, Phosphoric, or Hydrochloric Acid, has the power, at a temperature of l00o F., of dissolving albumen and fibrin. The amount dissolved by a given weight of Pepsine is the test of its activity. A temperature of 120o F. injures or destroys its solvent power. It should be preserved in a well-stoppered bottle.
Med. Prop. and Action. Taken internally, it produces no marked physiological effects beyond increasing the appetite for food, and, under certain conditions, allaying irritability of the stomach. It forms, in fact, a sort of artificial digestive, and in this character is undoubtedly useful in some cases: but the extravagant laudations of some individuals, combined with the fact that many spurious, inert articles are sold under its name, have served to bring it into disrepute. Dr. Garrod§ observes, that its beneficial action is somewhat difficult to explain, seeing that the ordinary doses of the drug are able to cause the solution of so small an amount of nitrogenized matters when out of the body, 15 grs. of Boudault's Pepsine dissolving but 60 grs. of dried fibrin. The dose should be taken immediately before meals, wrapped up in a wafer or in the first spoonful of soup; and precaution must be taken not immediately afterwards to eat food which is at a high temperature. Several modes of administration have been proposed: we shall mention the following: - 1. Elixir. Take (ordinary) Pepsine gr. lx., Distilled Water fl. drs. vj., White Wine fl. oz. j., Spirits of Wine fl. drs. iij., White Sugar oz. j., M. The dose, a tablespoouful, to be taken immediately after a meal. It has an agreeable taste, and women and children take it readily. 2. Pastiles or Lozenges. These are composed of Gum Arabic Paste, with a few drops of Essence of Lemon: each should contain four grains of (ordinary) Pepsine. Their agreeable taste is their great recommendation. The Syrup is an objectionable form. Some persons will take it readily spread on bread and butter, in the form of a sandwich. Pepsina Porci may be administered in the form of pills.
Dose of ordinary Pepsine, gr. xv. - gr. xx.; of Beale's Pepsina Porci, gr. ij. - gr. iv. To be taken immediately before or after or with a meal.
* See Lond. Pharm. Journ., 1859, vol. xvi pp. 278, 322; Ibid., 1860; and Ibid., vol. ii. N.S., p. 224.
Garrod, Ess. Mat. Med, and The-rap., p. 325. Op. cit. § Op. cit
2050 Therapeutic Uses. In Dyspepsia connected with deficient secretion of gastric juice, Pepsine seems to be especially indicated. Dr. Ballard* remarks that it is especially useful in gastric disturbances following the use of animal food. It often enables a patient who has not dared to attempt it, and could not do so without suffering, at once to eat it with impunity. The first dose usually in such cases produces an effect, and, after two or three more, no further discomfort is perceived. Even the severest cases of gastralgia are almost, as by a miracle, relieved by its use. If it fail to afford relief after three or more doses, it is probable either that the dyspepsia does not arise from a defect of the gastric secretion, or that some other condition predominates as its cause. It may be given conjoined with other medicines, which do not at all impede its therapeutic action: thus, with Hydrochlorate of Morphia, to relieve violent pain of the stomach; with Strychnine, to stimulate the peristaltic movements of this organ; with Nitrate of Bismuth, Lactate or Iodide of Iron, &c. The best formulae for its administration are given above.