This section is from the book "A Treatise On Therapeutics, And Pharmacology Or Materia Medica Vol1", by George B. Wood. Also available from Amazon: Part 1 and Part 2.
Origin and Properties. This consists of the leaves of Chimaphila umbellate-, a low evergreen plant, growing in the northern parts of Asia, Europe, and America, and abundant in the United States. These leaves are about an inch and a half long, wedge-shaped, pointed at the end, notched on the border, coriaceous, shining and of a bright sap-green colour on the upper surface, paler beneath, of a peculiar odour when fresh and bruised, and of an astringent, bitterish, somewhat sweetish, and not disagreeable taste. Water and alcohol extract their virtues.
These are tannic acid, and bitter extractive. It is probable that the matter indicated by the latter title is really complex, and that among its constituents is a peculiar principle, upon which all the virtues of the medicine, not connected with its astringency, depend. A crystallizable principle was obtained from the leaves by Mr. Samuel Fairbank, and denominated by him chimaphilin, though its claims to this title are doubtful, as it is probably destitute of active properties. (See U. S. Dispensatory, 12th ed).
The fresh leaves, bruised and applied to the skin, are said to be rubefacient and even vesicating. Internally, they are mildly astringent and tonic, with the property of somewhat increasing the secretion of urine, to which they probably impart some degree of remediate power. It is, I think, scarcely doubtful that their peculiar active principle, through which they stimulate the kidneys, passes off, either changed or unchanged, with the urine.
Pipsissewa was much employed by the aborigines of this country, to whom it owes the name by which it is now generally designated. It is sometimes called wintergreen; but, as this name has also been applied to Gaultheria procumbens, it should be abandoned for both. From the Indians the medicine passed into popular use, whence it was adopted by the profession. It was used chiefly in scrofula, rheumatism, and affections of the kidneys and urinary passages. Its diuretic powers have recommended it in dropsy, and it has been employed with asserted advantage in cases of this disease attended with debility; but little reliance can be placed upon its efficacy; and at best it should be used only as an adjuvant to other more powerful diuretics.
In scrofula, it is, I think, a valuable remedy. The late Dr. Joseph Parrish used it very extensively in this affection, and had great confidence in its powers. I have myself been in the habit of employing it, in cases of external scrofula, during the whole period of my practice, and have found few remedies which have appeared to me more efficacious.
Its mildly astringent and tonic properties adapt it admirably to the treatment of the scrofulous cachexia, in which a general laxity of the tissues, and debility of the functions, call for these two remedial influences; while the chronic character of the affection requires that the medication should be gentle, in order that it may be long sustained, without injury to the organs. In the earlier stages of the disease, I have been in the habit of directing, in connection with its use, a saline laxative twice or three times a week, and in anemic cases have had recourse also to the chaly-beates; but in many instances the pipsissewa has been the remedy mainly relied on. It has seemed to me to exercise a favourable alterative influence in scrofula, independently of its astringency and tonic power; but it is extremely difficult to discriminate, in affections of this kind, between the course of nature and the effects of remedies, so that it is proper to speak of the latter with some reserve. Fully aware of the necessity of this caution, I am still of opinion, as the result of considerable experience, that pipsissewa deserves to rank next to cod-liver oil, and the preparations of iodine and of iron, in the treatment of scrofula; and may often be usefully combined with one or more of these remedies. In order that its full effects may be obtained, it should be long continued, with interruptions now and then, should any considerable degree of fever supervene. In cases attended with ulcers of an indolent or flabby character, it may be used with advantage in decoction as a wash, at the same time that it is administered internally.
The resemblance in properties between pipsissewa and uva ursi would suggest the employment of the former also in complaints of the urinary organs; but I have had little experience with it in these affections, and cannot, therefore, speak with confidence of its utility, though it has been recommended by others.
The Decoction (Deooctum Chimaphilae, U. S.), prepared by boiling an ounce of the bruised leaves in a pint of water, for fifteen minutes, and then adding enough water to make a pint, is the most eligible form for administration, and may be taken in the dose of from two to four fluidounces four times a day. A pint may generally be taken by an adult in twenty-four hours without inconvenience. Some recommend the medicine as an ordinary drink in scrofula, in the form of beer, which may be made by fermenting together sugar, water, and the bruised leaves, with the addition of yeast An extract has also been recommended, and may be given in the dose of twenty or thirty grains.
The vegetable astringents above described are those probably most used in the United Suites, and are numerous enough to afford all desirable; latitude of choice to the physician. There are, however, several others having similar virtues, and some not less efficient than the preceding, with a general notice of which I shall content myself, from the fear of needlessly embarrassing the memory of the student, referring him for a particular account of them to the United States Dispensatory.
1. Red Rose (Rosa Gallica, U.S., Br.) consists of the unex-panded petals of Rosa Gallica, a European species of the rose, occasionally cultivated in our gardens as an ornamental plant. They are used chiefly in preparing a Confection (Confectio Rosae, U. S.), much employed as a vehicle for substances made into pill, and one of the ingredients of the officinal mercurial pill; and the Compound Infusion of Hoses (Infusum Rosae Compositum, U.S.), which consists of an infusion of the flowers made with the addition of a small proportion of sulphuric acid, and the virtues of which depend mainly on the latter ingredient. There is an officinal Honey of Roses (Mel Rosae, U.S.), and a Syrup (Syrupus Rosae Gallicae, U.S., Br.), both of which are used as agreeable additions to liquid astringent mixtures, such as mouth-washes and gargles, but have no great merit of their own.
2. Tormentil (Tormentilla, U.S.) is the root or rhizome of Potentilla Tormentilla, or septfoil, a European plant. This is a simple and powerful astringent, formerly much employed, but neglected since the general introduction of kino and rhatany into use.
3. Water Avens, the root of Geum rivale, indigenous in Europe and the United States, is tonic and powerfully astringent.
4. Hardhack (Spiraea, U.S.) is the root of Spiraea tomentosa, an indigenous shrub, all parts of which are bitter and astringent, though the root only is officinally recognized.
5. Pomegranate Rind (Granati Fructus Cortex, U. S.) is the rind of the fruit of Punica Granalum, or pomegranate tree, indigenous in the warmer latitudes of the old continent, and cultivated in the southern section of the United States. This is bitter and astringent, and is used chiefly as a gargle in sore-throat, in the form of decoction.
6. Bistort, the root of Polygonum Bistorta, growing in Europe and Northern Asia, was formerly much more used than at present, and is now seldom imported. It is an efficient astringent.
7. Alum-Root (Heuciiera, U.S.) is the root of Heuchera Americana, an indigenous plant, very strongly astringent.
8. Marsh Rosemary (Statice, U.S.) is the root of Statice Car-oliniana, an indigenous maritime plant. It is an active astringent, and is used to a considerable extent in some parts of the United States.
9. Persimmon (Diospyros, U.S.) is the unripe fruit of Diospyros Virginiana, an abundant indigenous tree. This fruit, though sweet and edible when quite mature, is in the unripe state exceedingly astringent, and may be beneficially employed whenever a simple vegetable astringent is indicated.