Mr. Greenhow,* to whom we are indebted for the following judicious remarks, states, that for several years, he has employed Aloes in every variety of dose, and that he has uniformly found that very small doses have answered all the purposes to be obtained from it; viz., substantial fseculent evacuations, attended with little or no irritation; and, for this purpose, from ij. to v. grains will be found sufficient. When administered in larger doses, it is apt to occasion griping, heat about the anus, and, if long continued, haemorrhoids; it also loses its effect of properly emptying the large intestines, producing frequent small evacuations, consisting principally of mucus, and attended with tenesmus, the abdomen being at the same time distended and tender, and the patient complaining that " the bowels feel as if scraped;" the pulse is sensibly quickened, and a sense of constriction is felt about the head.
The long-continued use of Aloes has a tendency to produce emaciation. Its action on the bowels becomes uncertain; mucus and bands of lymph, and sometimes, matter resembling fat, being passed with much tenesmus; and Mr. Greenhow thinks that he has seen Enteritis and stricture of the rectum follow its prolonged exhibition. He considers that Aloes exerts a decided influence on the kidneys, and states that he has repeatedly found, that when Squills, with other diuretics, failed to act, the addition of a small portion of Aloes has speedily produced a copious diuresis.
When Aloes is given simply as an aperient, the best vehicle is Extract of Gentian. Soap, Aromatic oils and Alkalies are said to diminish its purgative powers. One or two grains of Ipecacuanha, combined with each dose of Aloes, have the effect of diminishing, and often of altogether removing, its irritating effect upon the anus; and many persons labouring under Piles are not only able to take it in this way with impunity, but with advantage. If it produces griping, a few grains of Ext. Hyoscyami may be added. Care should be taken, in every case, that the Aloes be well pulverised. Dr. A. T. Thompson states that Camphor renders the action of Aloes more certain and less irritating.
Aloes should be given with caution - 1, to pregnant females: 2, to women suffering from dysmenorrhAea, menorrhagia, or organic disease of the uterus; 3, to hAemorrhoidal subjects, excepting in combination with Ipecacuanha; 4, During The Presence Of The Catamenia
Constipation. In Constipation dependent upon atony of the muscular coat of the stomach, which often supervenes upon Fevers and other debilitating diseases, Dr. C. Hastings recommends the following formula: - Aloes gr. v.; QuiniAe. Sulph. gr. j., 01. Menth. Pip. gutt. j. - ij. M. ft. pil. ter in die sumend. These should be persevered in for a few days, when the quantity of Aloes may be diminished. In the Constipation of Hysterical Females, the same physician recommends Aloes to be combined with Pil. Galban. Co. (Pharm., Lond.) The Pil. Aloes c. Myrrh. is also an eligible formula. At the same time, enemas containing Assaftida or Turpentine should be employed. In the Habitual Constipation of Infants, Dr. Merriman states that he has known a liniment composed of one part of Tincture of Aloes and two of Soap Liniment, rubbed over the abdomen for five or ten minutes daily, very effectual in keeping the bowels regular.
S3. In Constipation, from whatever cause, Dr. Mettauer speaks in the highest terms of the following formula: - Aloes Soc. iiss., SodAe super Carb. (?) vj., Aq. Oiv., Spt. Lavand. Co. fij. M. Digest for 14 days. Dose, fj. - fss. an hour after a full meal.
* Medical Gazette, Nov. 19, 1836. Cyc. Pract. Med., vol. iv. p. 582.
Brit. and For. Med. Rev. April, 1851.
84. In Dyspepsia, occurring in persons of a relaxed habit, or in those who have been debilitated by long illness, particularly if there is reason to believe the duodenum to be implicated, Aloes (gr. ij. - iv.) combined with a grain or two of Ipecacuanha, repeated two or three times a week, is often attended with decided benefit.