The bark of the root of Rhus aromatica, Aiton.
COMMON NAME: Fragrant sumach, Sweet sumach.
ILLUSTRATION: Gray's Genera, Plate 160.
Botanical Source.—This is a small, bushy shrub, growing from 2 to 6 feet high, and found in clumps throughout sections of the eastern United States, in rocky situations. The leaves are trifoliate, and on stalks about 1 inch in length. The 3 leaflets are sessile, and covered with a short velvety pubescence when young. The terminal leaflet is considerably larger than the lateral leaflets, from 1 to 2 inches in length, and about two-thirds as wide. They are entire and tapering at the base, acute, and have 8 or 10 crenate teeth at the apex. The flowers are small, greenish-yellow, and open in April before the leaves; they are in stalked, spiked, ament-like clusters, and, before flowering, have the appearance of an unexpanded catkin. The sepals, petals, and stamens are in fives, and the pistil is a 1-ovuled ovary, with 3 short styles. The fruit is a small red drupe, about the size of a pea, covered with dense, white pubescence. They are produced in clusters of about a dozen, and are on stalks about ½ inch long; each one contains a single flattened seed. A variety (var. trilobiata, Gray. with small, smooth leaflets, generally less than an inch in length, is common throughout Texas and the western states and territories.
History, Description, and Chemical Composition.—The part employed in medicine is the root, or the bark of the root. It has attained some little local reputation heretofore, but was unknown to the medical profession until introduced by Dr. McClanahan, in 1879. When dry, the root is from ¼ to 1 inch in diameter, and appears in the market in pieces of from 6 inches to 2 feet in length. The bark is of a dark, rusty-brown color externally, and a pink or walnut color below the cork. It is about ⅛ of an inch in thickness, and throughout the inner bark of a prime article are little cavities containing a transparent balsam, somewhat resembling balsam of fir. The wood is white or yellowish. When fresh, the wounded bark exudes a turpentine-like balsam, or solution of a resin in some volatile oil, which dries to a glossy tear or layer. The bark is astringent, but, undoubtedly, the turpentine-like balsam likewise possesses considerable medicinal value. Alcohol extracts this substance, and the addition of water to the tincture produces a milkiness. In making the tincture of either the fresh or dry bark, alcohol alone should be used, and any addition of water is objectionable. Quantitative analysis of the drug by H. W. Harper (Amer. Jour. Pharm.) showed the presence of volatile and fixed oils, several resins and wax, butyric acid, tannin, glucose, gum, starch, oxalates, etc., and 13.8 per cent of ash. The berries were examined for acids by Edo Claassen (Pharm. Rundschau, 1890, p. 262), and yielded 10.65 per cent of citric and a small quantity of malic acids.
Action, Medical Uses, and Dosage.—This exceedingly valuable medicine was introduced by J. T. McClanahan, M. D., Booneville, Mo. (Ec. Med. Jour., 1879, p. 317). At first, the use of this remedy was confined to the treatment of diabetes, and other excessive discharges from the kidneys and the bladder, as well as to cases of incipient albuminuria. More recently, in addition to the above-named diseases, it has been largely employed with advantage in urethral irritations, uterine leucorrhoea, cholera infantum, diarrhoea, dysentery, chronic laryngitis, chronic bronchitis, and especially in the enuresis of children and of aged persons.
While it is of undoubted value in many hemorrhagic states, particularly in chronic hematuria, a malarial form of which is quite common in the southern states, its chief value is in enuresis, with marked atony and chronic irritability of the urinary passages, whether in young or old subjects. The favorite remedies for "bed-wetting" are Rhus aromatica, belladonna, and thuja. Sometimes this affection yields to Rhus aromatica alone; sometimes a combination, as indicated, must be used. Fragrant sumach is indicated in all cases of over-activity of the kidneys, but is always contraindicated when there is active inflammation. A patient suffering, for several years, from catarrh of the bladder and hypertrophy of the prostate, with excruciating pain during micturition, necessitating the continued use of a soft catheter, the introduction of which invariably proved painful, was relieved by fragrant sumach. After exhausting the employment of all recognized remedies for the patient's condition, together with the use of the water at the Hot Springs of Arkansas, etc., without the least benefit, as a dernier ressort, the patient was placed upon teaspoonful doses, 3 or 4 times daily, of the fluid extract of Rhus aromatica. In 3 weeks' time the symptoms were all removed, and the prostate so far reduced that the use of the soft catheter became unnecessary. The patient was 65 years old and subsequently voided urine as freely and as painlessly as a boy of 18 years (J. King).
Inflammatory symptoms being absent, it may be employed in passive uterine hemorrhage, hemorrhage of the bowels, as in chronic bloody-flux (not in acute dysentery), chronic painful vesical catarrh, and in phthisis, to control hemorrhage when small in amount, and to restrain the accompanying diarrhoea and night-sweats. In bronchitis, with profuse, blood-streaked expectoration, it may be given with confidence. A good form of administration is as follows: R Specific fragrant sumach, ℥ss; glycerin, ℥iijss. Mix. Sig. Dose, from ½ to 1 teaspoonful every 3 or 4 hours. This remedy is reputed useful in purpura hemorrhagica. The forms of administration now preferred are specific fragrant sumach and the fluid extract, of which the dose of either varies from 5 to 60 minims, repeated every 3 or 4 hours. It may be taken in water, in glycerin and water, and in solution of pure gelatin, or in syrup, when these vehicles are not contraindicated.
Specific Indications and Uses.—Not the remedy for active conditions. As given by its introducer, Dr. McClanahan, the specific indications are: "Stools profuse, skin cool and sallow, pulse small and feeble, loss of flesh, abdomen flabby, tongue pale, trembling and moist, trembling in lower limbs; general sense of lassitude and languor. Dose for infants, 10 to 20 drops in a half-glass of water, teaspoonful as often as necessary; for children, perhaps 5 drops of the first dilution" (Ec. Med. Jour., 1879, p. 317). To these may be added large, painless diarrhoeal discharges; nocturnal enuresis, from weakness of spincter vesicae; prostatic enlargement; and malarial haeematuria.