Cascara Sagrada, B.P. Cascara Sagrada.
Synonyms.—Sacred Bark; Rhamni Purshiani Cortex.
Cascara sagrada (Rhamnus Purshiana, U.S.P.) is the dried bark of Rhamnus purshianus, DC. (N.O. Rhamneae), a shrub growing in North California, Oregon, and Washington. It is collected in the spring and early summer, and dried in the shade. It is generally considered that the action of the bark becomes milder and less emetic by keeping; hence matured bark (three years old) is preferred for pharmaceutical purposes. The bark occurs in quilled, channelled, or curved pieces, varying considerably in size, but often about 10 centimetres long, 1 to 2 centimetres wide, and 1 to 2 millimetres thick, thin bark being preferred for use in pharmacy. The cork is nearly smooth, dark purplish-brown in colour, and bears scattered lenticels, but in most pieces the cork is more or less completely covered by a whitish coat of lichens; the inner surface is of a yellowish-brown or dark brown colour, and faintly striated and corrugated. It breaks with a short fracture, which is somewhat fibrous near the inner surface. The transverse section exhibits a narrow purplish cork, a yellowish-grey cortex, in which groups of sclerenchymatous cells may be distinguished, and a brownish-yellow bast, containing wavy, medullary rays. The odour is characteristic, though not powerful; the taste is nauseous and persistently bitter.
Constituents.—The constituents of the bark are but imperfectly known. It has been proved to contain emodin and an allied substance, possibly identical with the frangula-emodin of alder buckthorn bark; fat (2 per cent.), glucose, and a hydrolytic enzyme have also been found in it, as well as a small quantity of a substance yielding, on treatment with acids, syringic acid. Neither chrysophanic acid nor chrysarobin is present. The assertion has been made that the bark contains glucosides which yield on hydrolysis emodin, chrysophanic acid, etc., but the evidence on this point is conflicting. The bitter principle is apparently a lactone, which is converted into less bitter salts by treatment with alkalies; upon this property the methods of making tasteless liquid extracts are based, but simultaneous loss of activity occurs. The total amount of oxymethylanthraquinones present in the bark, or extractable after boiling with dilute sulphuric acid, has been estimated to be from 1.4 to 2 per cent., but although these bodies are laxative, this proportion can scarcely influence the activity of the drug. The principal purgative constituent of cascara bark remains, therefore, still unknown. The drug yields about 5 per cent. of ash, and about 27 per cent. of aqueous extractive.
Action and Uses.—Cascara sagrada is a mild laxative. It acts principally on the large intestine and empties the rectum, producing no inflammation. It is suitable for delicate and elderly persons, and is a good laxative in haemorrhoidal conditions; small repeated doses are preferred in habitual constipation. It is administered in the form of liquid extract of cascara in a mixture combined with glycerin, or alkalies, especially aromatic spirit of ammonia; mixtures with mineral acids and salts are often unpresentable in appearance. Elixir Cascarae and Syrupus Cascarae Aromaticus are not unpleasant liquid forms of extract of cascara; for children, the miscible liquid extract may be given with glycerin and syrup, flavoured with liquid extract of liquorice. On account of the unpleasant taste of the liquid extract, it is very frequently given in gelatin capsules, containing the equivalent of 6 to 30 decimils (0.6 to 3.0 milliliters) (10 to 45 minims) of liquid extract in each; they are readily soluble. Tablets contain from 6 to 30 centigrams (1 to 5 grains) of solid extract, and pills are prepared of similar strengths. The latter are best massed with 60 per cent. alcohol, adding a little powdered gum acacia. Extract of cascara is frequently combined with euonymin, nux vomica, aloin, belladonna, or strychnine, in pill or tablet form.
- Elixir Cascarae, B.P.C.—ELIXIR OF CASCARA. Syn.—Aromatic Cascara. 1 (liquid extract) in 4.
- 'The nauseous taste of cascara is well disguised in this preparation, without impairment of its properties. Dose.—2 mils (30 minims) for repeated administration; for a single administration, 4 to 8 mils (1 to 2 fluid drachms).
- Elixir Cascarae et Euonymini, B.P.C.—ELIXIR OF CASCARA AND EUONYMIN.
- Extract of euonymus, 1; tincture of lemon, 25; miscible liquid extract of cascara, 50; glycerin, to 100. An aperient and cholagogue. Dose.—2 to 4 mils (½ to 1 fluid drachm).
- Extractum Cascarae Sagradae, B.P.—EXTRACT OF CASCARA SAGRADA. Syn. Extractum Cascarae; Extract of Cascara; Extractum Rhamni Purshiani.
- Moisten the cascara sagrada, in No. 20 powder, with distilled water and set aside for a few hours; then pack loosely in a percolator, exhaust by percolation with more water, and evaporate to dryness on a water-bath. This extract may be made into pills with diluted alcohol, adding a trace of acacia powder. For inclosure in gelatin capsules, it should be finely powdered and mixed into a soft mass with liquid paraffin. The extract is largely used in tablet form (See Tablettae Cascarae Sagradae), and is commonly prescribed with the extracts of belladonna and nux vomica, or with aloin and euonymin. Dose.—1 to 5 decigrams (2 to 8 grains).
- Extractum Cascarae Sagradae Liquidum, B.P.—LIQUID EXTRACT OF CASCARA SAGRADA. Syn.—Extractum Cascarae Liquidum; Liquid Extract of Cascara; Extractum Rhamni Purshiani Liquidum.
- Cascara sagrada, in No. 20 powder, 100; alcohol, 20; distilled water, sufficient to produce 100. Moisten the drug with 75 of the water, set the mixture aside for six hours, then exhaust by percolation with distilled water; evaporate the resulting percolate to 60, and add the alcohol, previously mixed with an equal volume of water, or sufficient to produce 100. Liquid extract of cascara is incompatible with acids and with strong solutions of mineral salts. It is miscible with alkalies, especially with aromatic spirit of ammonia; such mixtures gradually lose their bitter taste. Liquid extract of cascara mixes well with glycerin, and is frequently prescribed therewith. Dose.—2 to 4 mils (½ to 1 fluid drachm).
- Extractum Cascarae Liquidum Miscibile, B.P.C.—MISCIBLE LIQUID EXTRACT OF CASCARA. 1 in 1.
- Used in cases where the bitter taste of Extractum Cascarae Sagradae Liquidum is found objectionable. This preparation is an improvement upon, and more active than, so-called tasteless extracts of cascara, which are made by mixing lime or magnesia with the powdered bark before percolation. Dose.—2 to 4 mils (½ to 1 fluid drachm).
- Extractum Rhamni Purshianae, U.S.P.—EXTRACT OF CASCARA SAGRADA, U.S.P.
- Cascara sagrada, in No. 60, powder, 400; alcohol (12 per cent.), a sufficient quantity; liquorice root, in No. 80 powder, to 100. Average dose.—2 ½ decigrams (4 grains).
- Fluidextractum Rhamni Purshianae, U.S.P.—FLUIDEXTRACT OF CASCARA SAGRADA.
- Cascara sagrada, in No. 40 powder, 100; a mixture of alcohol (95 per cent.), 1, and distilled water, 1 ½ , to 100. Average dose.—1 mil (15 minims).
- Fluidextractum Rhamni Purshianae Aromaticum, U.S.P.—AROMATIC FLUID EXTRACT OF CASCARA SAGRADA.
- Cascara sagrada, in No. 40 powder, 100; liquorice root, in No. 30 powder, 10; magnesium oxide, 12.5; glycerin, 25; compound spirit of orange, 1; distilled water, alcohol (95 per cent.), and alcohol (49 per cent.) to 100; Mix thoroughly the cascara sagrada, liquorice root, and magnesium oxide, and macerate for twelve hours with 200 of water, dry at a gentle heat; mix the glycerin with 50 of the alcohol and 25 of distilled water; moisten the powder with 40 of this mixture, pack in a percolator, add enough menstruum to saturate the powder and leave a stratum above it; macerate for forty-eight hours, then percolate first with the remainder of the menstruum, then with alcohol (49 per cent.), until exhausted; reserve the first 80 of the percolate, evaporate the remainder to a soft extract; dissolve this in the reserved portion, add the compound spirit of orange, and make up to the required volume with alcohol (49 per cent.). Average dose.—1 mil (15 minims).
- Mistura Cascarae, B.P.C.—CASCARA MIXTURE. Syn.—Mistura Laxativa; Laxative Mixture.
- Each fluid ounce contains 30 minims of liquid extract of cascara sagrada, with liquid extract of liquorice, aromatic spirit of ammonia and chloroform water. Employed as a mild laxative in chronic constipation. The ammonia prevents the formation of an unsightly deposit, and the mixture becomes less bitter after standing several weeks. Dose.—15 to 30 mils (½ to 1 fluid ounce).
- Mistura Cascarae Composita, B.P.C.—COMPOUND CASCARA MIXTURE.
- Each fluid ounce contains 20 minims of liquid extract of cascara, 5 minims each of tincture of belladonna and tincture of nux vomica, with liquid extract of liquorice, aromatic spirit of ammonia, and chloroform water. The addition of the tinctures of nux vomica and belladonna increases the laxative action of the cascara, and the atropine present removes the sense of griping. This mixture gradually loses much of its bitterness, Dose.—15 to 30 mils (½ to 1 fluid ounce).
- Pastillus Cascarae, B.P.C.—CASCARA PASTILLE.
- Each pastille contains extract of cascara sagrada, 12 centigrams (2 grains).
- Pilulae Cascarae, Belladonnae et Nucis Vomicae, B.P.C.—CASCARA, BELLADONNA, AND NUX VOMICA PILLS.
- Each pill contains ⅘ grain of extract of cascara sagrada; 1/10 grain of extract of nux vomica; 1/10 grain of alcoholic extract of belladonna. Dose.—1 to 3 pills.
- Pilulae Cascarae et Euonymini, B.P.C.—CASCARA AND EUONYMIN PILLS.
- Each pill contains ½ grain of extract of cascara sagrada; ¼ grain of euonymin; ¼ grain of green extract of hyoscyamus. Dose.—1 to 4 pills.
- Syrupus Cascarae, B.P.C.—SYRUP OF CASCARA.
- Two fluid drachms contain 18 minims of miscible liquid extract of cascara, with syrup and glycerin. Dose.—2 to 8 mils (½ to 2 fluid drachms).
- Syrupus Cascarae Aromaticus, B.P.—AROMATIC SYRUP OF CASCARA.
- Liquid extract of cascara sagrada, 40; tincture of orange, 10; alcohol, 5 cinnamon water, 15; syrup, 30. Mix the liquid extract with the cinnamon water, tincture of orange, and alcohol; then add the syrup. The disagreeable taste of cascara is well disguised in this preparation. It is a favourite remedy in habitual constipation. Dose.—2 to 8 mils (½ to 2 fluid drachms).
- Tablettae Cascarae, B.P.C.—CASCARA TABLETS.
- Extract of cascara sagrada, 1, 2, 3, or 5 grains, in each tablet. Dose.—6 to 60 centigrams (1 to 10 grains).
- Tinctura Laxativa, B.P.C.—LAXATIVE TINCTURE.
- Liquid extract of cascara, 25; tincture of nux vomica, 12.5; tincture of belladonna, 12.5; aromatic spirit of ammonia and spirit of chloroform to 100; Dose.—1 to 4 mils (15 to 60 minims).