. Active Ingredients. - The two elements which, probably, are alone efficient, are berberine and starch; for the alkaloid calumbine, C21H13O1, is most likely inert.1 Berberine, C20H17NO4 exists in the root in combination with calumbic acid; its action will be discussed below. It forms, out of an aqueous solution, small glittering yellow crystals, which have a bitter taste and a neutral reaction. At a temperature of 120° C. it melts into a reddish-brown resinous mass. It is little soluble in cold, much more soluble in boiling water; very soluble in alcohol; little so in benzol; insoluble in ether and petroleum-ether. Charcoal precipitates it from a solution, but alcohol will set it free. Cold water precipitates it from its solution in alcohol. Its solutions have no influence on the plane of polarization. The starch is a most important element, and exists in the root to the amount of 33 per cent.

Physiological Action. - Although calumba itself can hardly be spoken of as having any toxic effect, since it would probably be impossible to administer the drug in sufficient quantities to produce such action, there is at least one ingredient of it - berberine - which is possessed of poisonous properties. These, however, are weak and variable.

Berberine, it will be remembered, has been mentioned as a constituent of several plants of the ranunculaceous family (Podophyllum, Hydrastis, etc.). Its actions have been investigated by Falck 2 and Guenste,3 and no doubt is left that, upon certain animals at any rate, it can act as a fatal poison. Rabbits died in from eight to forty hours after a subcutaneous injection of 7 1/2 to 15 grains. Dogs, on the other hand, resisted all at tempts to kill them, even by the largest doses injected into the blood. Given to them by the stomach, berberine produced some temporary tremor, restlessness, and thirst, and a few watery evacuations. Injected into the veins, it produced salivation, watery evacuations, and (after a second injection) convulsive shudderings followed by paralysis (especially of the hind limbs) and difficult and frequent breathing; but all these symptoms gradually wore off, the tremor being the last to disappear. In pigeons and fowls repeated injections of berberine solution into the crop caused vomiting, watery evacuations, quick breathing, and loss of appetite; given in pills amounting to a quantum of four to eight grains with each day's food, the drug produced progressive loss of appetite, to the extent of causing marked inanition.

1 This opinion is based on the absolutely negative results of the researches of Schroff, and of those of Falck and Guenste; but other authors have conjectured, probably on the sole ground of its bitterness, that calumbine is the active principle of calumba root.

2 Deutsche Klinik, 14, 15, 1854.

3 De Columbino et Berberino Observationes. Inaug. Diss. Marburg, 1851.

On man, berberine has never been known to produce actively poisonous effects; but several observers record pain in the belly and watery diarrhoea, as the result of swallowing doses of 7 to 15 grains - effects which at least are remarkable, and different from those which result either from the employment of small doses of berberine itself, or from the ordinary medicinal employment of ounce doses of the infusion of ca-lumba twice or three times daily.

Therapeutic Action. - Calumba is powerfully tonic and antiseptic, and when resorted to for medicinal use has the great recommendation of being free from nauseous flavor. Another excellent character of the drug is that, while free from acridity and astringency, there exists in it so considerable an amount of starch that it becomes demulcent. Of all known tonics, moreover, calumba is the least likely to disagree with the stomach. It is anti-emetic; it promotes the appetite, and assists digestion, yet is not stimulant. The excellent tonic and stomachic effects are produced without any accompanying nausea, sickness, or headache - symptoms which so frequently follow the exhibition of tonics - and hence, it can be usefully employed when other remedies of its class would be instantly rejected. So far, indeed, is calumba from ever being a cause of sickness, that its qualities may be pronounced to be exactly the reverse; in a word, as just now said, it is anti-emetic. Not only does it arrest the vomiting produced by tartar-emetic and ipecacuanha, but, when combined with these medicines, their operation is rendered milder.

Calumba is employed with great benefit to the patient in all those affections of the stomach and bowels which are accompanied by an increased secretion of vitiated bile. In a languid state of the stomach also, especially when nausea and flatulence become troublesome, experience has fully justified its reputation. So, again, in the "bilious attacks," as they are commonly termed, to which delicate females are often subject, the conjoined use of infusion of calumba and of effervescing draughts is in most cases exceedingly beneficial; while in dysentery, when the inflammatory symptoms have subsided, it has proved so serviceable that, in Germany, calumba goes by the name of Ruhrwurzel, or "dysentery-root." The utility of the drug is specially observable when the dysentery is chronic, and attended by ulceration of the colon.

In habitual diarrhoea, when tonics are admissible, calumba possesses value similar to that displayed in dysentery.

Vomiting caused by kidney disease and renal calculi has been alleviated by the employment of calumba. The anti-emetic effects have also been found particularly useful in cholera. Combined with soda, powdered culumba-root is serviceable also in pyrosis.

After attacks of fever, when cinchona or disulphate of quinia is about to be exhibited, calumba, in infusion, is an excellent preparation. In hectic fever, and in the last stages of phthisis pulmonalis, calumba has been found an excellent agent for the checking of colliquative diarrhoea, also in allaying irritability, and imparting to the stomach a certain amount of vigor.

Women, during the early period of pregnancy, often suffer from a distressing amount of vomiting. This is frequently allayed by the use of calumba; and if, after confinement, puerperal fever should supervene, calumba is, according to Denman, preferable to cinchona.

The vomiting and diarrhoea which often accompany dentition, are likewise amenable to the influence of this excellent medicine.

Sydney Ringer (p. 410) speaks of calumba in the following words: "Calumba is used as a tonic to increase both appetite and digestion. It has a slight irritant action upon the stomach, as indeed most bitter substances have, and is considered by this property to be able to set aside slight changes in the mucous coat of the stomach, and, in this indirect way, to assist appetite and digestion. It is easily tolerated by the stomach, and is thus employed when this organ is in a weak state, as during the convalescence from an acute disease, when it is often found that calumba is borne with benefit, while stronger tonics may upset the stomach."

Preparations and Dose. - Extract. Calumbae Fluidum, m v.xxx. (.30 - 2.): Infus. Calumbae,

Menispermaceae Calumba Cocculus Palmatus 5

- ij. (15. - 60.); Tinct. Ualumb., 3 i - ij- (4. - 8.)