Active Ingredients. - The constituents which represent nearly the whole of copaiva are two, a resin, in the proportion of about 52 per cent., and a volatile oil, to the extent of 40 per cent. These proportions vary, however, with age and exposure. The resin (copaivic acid, C20H10O2), is crystalline, and resembles common resin or pinic acid. The volatile oil is a colorless liquid, having the smell and taste of copaiva, and is isomeric with oil of turpentine, i.e., it consists of C10H16. In addition to these two principal constituents, there is about 2 per cent. of a soft brown resinoid matter, the nature of which is unknown. It is more abundant in old than in recent copaiva; and is soluble in anhydrous alcohol, ether, and the oils, both fixed and volatile.

Copaiva itself becomes darker in color, and more dense, with age and exposure to the atmosphere. Like other oleo-resins it is insoluble in water, but soluble in alcohol, ether, and oils, also in an equal volume of benzol. With alkalies it forms a kind of soap, insoluble in water.

Physiological Action. - The most complete inquiries as to the operation of copaiva, when taken into the system, are undoubtedly those of Ricord. He shows that the skin, the bronchial tubes, the digestive organs, and the whole of the mucous surfaces, are affected by it; the nervous centres also, occasionally; and the urinary apparatus most markedly and uniformly. The action upon the digestive organs is manifested in its causing heat in the pit of the stomach; in its lessening the desire for food, and giving rise to nausea and wretching, or eructations that possess the peculiar taste and odor of the medicine. When copaiva cannot be tolerated by the stomach, purging of the bowels often follows; the alvine secretions are sometimes bloody, and attended by mucous discharge, also by a sense of burning in the region of the sphincter ani, and by violent tenesmus.

The influence upon the urinary organs is shown by diuretic effects, and by the changed quality of the secretion, which acquires a deeper color, a certain degree of bitterness, and a slightly balsamic odor, or, at times, the smell of violets. This peculiar odor is perceptible, likewise, in the stools. After standing a little while, the urine of persons who have taken copaiva often presents, also, a filmy covering, or delicate pellicle, which is apt to be iridescent; the suspension in it of a certain resinous matter produces, at the same time, a very manifest turbidity. Should the dose have been unduly large, micturition becomes too frequent, and is preceded and followed by itching, smarting, and burning, in the urethral passage, and during its progress is accompanied by heat and tenus-mus, and even by haematuria and ischuria. The urine deposits, likewise, a sediment resembling albumen, and which properly consists of vesical and urethral mucus.

(There is little doubt that the resin of copaiva is the efficient ingredient of the balsam, especially for diuretic purposes, a fact so little appreciated by the profession, that a distiller of the oil some time since informed the editor that finding no market for the resin, he used it as fuel in his factory.)

While these local results appear, the whole system becomes excited. The pulse is quickened, and becomes fuller, and thirst and headache supervene.

The influence thus exerted upon the urine and the urinary organs proves that copaiva enters the general circulation. This is further indicated by its tainting the breath, and by its action, eruptions being produced which resemble urticaria and roseola, or, in some cases, they are like rubeola. These symptoms, however, are said to be concomitant only with imperfect medicinal action of the drug, or to appear when the system generally is repugnant to it. Even in moderate doses, the action of copaiva upon the mucous membranes, especially those of the urethra, is very striking; and it may be added that among the early symptoms of its operation are increased flow of saliva, and a flatulent rumbling in the bowels, followed by colicky pains and a desire to vomit.

The effects of copaiva upon the respiratory tract are shown in its producing irritation in the larynx and the bronchi; dryness also, in the larynx, huskiness in the chest, and dry and painful cough, in connection with which there is expectoration of a semi-purulent, greenish, and nauseously smelling mucus.

And lastly, in regard to the influence of copaiva upon the nervous system, it is said that the continued use of it has been followed by epileptic convulsions.

The physiological action of the oil of copaiva is nearly similar to what has been described, but it is not so powerful. Micturition is increased; the stools become frequent and watery, and sometimes bloody; the breathing is hurried; there is palpitation of the heart; and, usually, restlessness. Eventually the medicine is excreted by the customary channels.

Therapeutic Action. - The great and special use of copaiva is in the chronic stages of gonorrhoea, also in gleet and in fluor albus.

Women who may be suffering from gonorrhoea are less successfully treated with it than men, since in woman gonorrhoea is not confined to the mucous lining of the urethra, but extends to that of the vagina, whence it is obvious that the disease cannot be benefited to the same extent by the local action of the medicine, which, under all circumstances, is its special and paramount recommendation. Copaiva has, likewise, been employed with success in chronic inflammation of the bladder; also, according to Armstrong (1818) and other writers, in leucorrhoea.

Favorable mention is also made of copaiva in cases of chronic pulmonary catarrh. But it is only adapted for long-standing cases and for torpid constitutions.

In chronic inflammation of the mucous membrane of the bowels, especially of the colon and of the rectum, copaiva has again proved a valuable agent.

Cullen, in his Materia Medica, further commends it for use in haemorrhoids.

Formerly, again, copaiva was used as an application to wounds and ulcers.

In the treatment of gonorrhoea - the complaint for which copaiva is so popular a remedy - two methods of exhibition are resorted to. The first is to give the medicine at the very commencement of the disorder, so as to arrest or suppress it; the other is to delay the use of copaiva until the inflammatory symptoms have subsided. The first method is that employed (at all events, to some extent) in America. In Europe, though it has been followed by some practitioners for nearly seventy years, it is disregarded for the sake of the second. This second method is commenced with antiphlogistic and soothing treatment, and when the inflammation has much abated, the copaiva is given with a view to reducing or stopping the discharge. Hunter, Sir Astley Cooper, and Lawrence, all observed this latter method, and there can be no question that it is the safest; for, independently of the usefulness of the preliminary antiphlogistic treatment, instances have occurrred when copaiva given in the early stages of gonorrhoea has actually aggravated the symptoms.

In administration, Dr. Chapman recommends that the copaiva be poured upon half a wineglassful of water, to which is then to be added a small quantity of some bitter tincture. By this means the copaiva is collected into a small globule which may easily be swallowed, the taste, so nauseous to many patients, being entirely masked.

Ordinarily, copaiva is prescribed in the form of emulsion, in doses of from half a drachm to a drachm thrice a day.

It may also be taken upon sugar, and in this way is more disposed to act upon the urinary organs.

Combined with the liquor potassae, its effects in the last stage of gonorrhoea are much increased.

Preparations and Dose. - Capaiba x. - xx. (.60 - 1.20); Oleum

Copaibae 3 ss. - 3 j. (2. - 4.); Resina Copaiba: (not officinal), gr. ij. - v. (.12 - .30). Unless thoroughly triturated with milk sugar, the resin is apt to pass the bowels unchanged.