This section is from the book "A Treatise On Therapeutics, And Pharmacology Or Materia Medica Vol2", by George B. Wood. Also available from Amazon: Part 1 and Part 2.
Though this anthelmintic is little used abroad, yet, in this country, it stands at the very head of the medicines employed against the common roundworm. it is the root of Spigelia Marilandica or Carolina pink, a very pretty herbaceous perennial, growing abundantly in our Southern and Southwestern States.
Pinkroot consists of a knotty head, and numerous slender, long, crooked, and branching radicles or fibres attached to it. its colour is yellowish or grayish-brown, its smell faint and peculiar, and its taste sweetish and somewhat bitter, but not very unpleasant. The powder is grayish. Water and alcohol extract its virtues. The active principle has not been satisfactorily isolated; though Feneulle obtained from it a brown, bitter, nauseous matter, which, when taken internally, produced some of the characteristic effects of the root.
The leaves have similar virtues with the root, but are much feebler, and have been very properly, I think, rejected by our officinal code. They were formerly more used than at present.
Remedial Effects and Uses. Though not employed with reference to its effect on the system, pinkroot is not without some power of affecting the functions.' Taken somewhat more freely than is ordinarily considered necessary for its anthelmintic effects, it occasionally operates as a cathartic; but not certainly; so that it cannot be relied on in this capacity. Another effect which it produces in large doses, and which is occasionally seen from it in nervous children, when given moderately as an anthelmintic, is disturbance of the nervous system; as indicated by giddiness, dimness of vision, dilated pupils, and irregular muscular contractions, amounting sometimes to convulsions. Ludicrous distortions of the facial muscles are often noticed, and especially spasmodic movements of the eyelids. Death in two instances has been thought to proceed from convulsions dependent on this cause in children; but the affection is so common from other causes in the very young, even from the worms themselves, that it would be extremely difficult to determine, with certainty, in any particular case, that the fatal result and the administration of the medicine were anything more than coincidences. Though I have witnessed some of these nervous disturbances in children, I never saw an instance in which I thought there was danger of life; and, within the circle of my personal observation, I have never heard of such a case. These effects on the nervous system scarcely ever occur when the medicine purges; and hence the propriety of the simultaneous administration of a cathartic with this particular vermifuge.
Experience has, I think, abundantly established the efficiency of pink-root as an anthelmintic. A knowledge of this property of the medicine was derived from the Cherokee Indians, in whose original country the plant grew abundantly; and to Drs. Lining, Gardner, and Chalmers, of South Carolina, the profession are indebted for its first introduction to their notice.
Spigelia is given in substance, infusion, or fluid extract. The dose of the powder is for a child three or four years old from ten to twenty grains; for an adult one or two drachms. When the medicine is given in single doses with a purgative, the larger quantity may be administered; when in doses repeated twice or more frequently in the day, the smaller.
Sometimes a full dose of the powder is given at once with a purgative dose of calomel, and repeated at intervals of three or four days; care being taken in regard to each dose, that, if it do not operate in six or eight hours, it should be followed by a dose of castor oil. For children, the compound is conveniently given at bedtime, and the oil, if required, next morning.
Another method is to administer a dose of the powder morning and evening for several days in succession, and follow it by a brisk cathartic, which, in the cases of children, may be a dose of calomel, in adults, of senna tea with sulphate of magnesia.
The infusion is more used than the powder. it is sometimes given alone, repeated as above, and in like manner followed by a purgative; but a more frequent plan, and, I think, a better, is to give it in conjunction with senna, according to a formula which will be mentioned below.
Recently the fluid extract has come into extensive use, and, as it concentrates the virtues of the medicine within a small bulk, and is thus more easily administered, is generally preferred.
Infusion of Pinkroot (infusum Spigeliae, U. S.) is made in the proportion of half an ounce of the root to a pint of boiling water. The dose for a child, from two to four years old, is from half a fluidounce to a fluidounce, for an adult from four to eight fluidounces, morning and evening. it is rendered more efficient by the addition of half an ounce of senna, and, in order to obviate the griping effect of this cathartic, a drachm or two of cardamom or fennel-seed, and an ounce of manna.
The Fluid Extract of Pinkroot (Extractum Spigeliae Fluidum, U. S.) is a concentrated tincture of spigelia with the addition of sugar, to improve its flavour and aid in its preservation. A fluidounce Of it should contain the virtues of a troyounce of the root; and the dose is from ten to twenty minims for a child of two or three years, and one or two fluidrachms for an adult. it is, however, more used as an ingredient of the fluid extract of pinkroot and senna than alone.
Fluid Extract of Pinkroot and Senna (Extractum Spigeliae et Sennae Fluidum, U. S.) is also an officinal of the U. S. Pharmacopoeia. it consists of ten fluidounces of the simple fluid extract just described, six fluidounces of fluid extract of senna, half a troyounce of carbonate of potassa, and twenty minims, each, of the oils of anise and caraway. The oils are intended to obviate griping, and the carbonate of potassa to hold a resinous matter in solution, and correct the action of senna. it is an excellent preparation, and easily administered. The dose is from thirty minims to a fluidrachm for children, from two fluidrachms to half a fluidounce for an adult.