Granatum.
The dried bark of the stems and roots of Punica Granatum, Linné (Nat. Ord. Punicaceae). India, southwestern Asia, and the Mediterranean shores; naturalized and cultivated in warm latitudes. Dose, 30 grains.
Common Names: Pomegranate, Pomegranate Root Bark.
Principal Constituents.—Pelletierine or punicine (½ per cent), methyl-, pseudo-, and isopelletierine, all alkaloids, and punico-tannic acid (20 per cent).
Preparations.—1. Pelletierinae Tannas, Pelletierine Tannate. (Contains in varying proportions, in admixture, the four alkaloids mentioned above.) A pale-yellow, noncrystalline powder, without odor, and an astringent taste. Soluble in alcohol and less readily in water. Dose, 4 grains.
2. Decoctum Granati, Decoction of Pomegranate Bark (see below).
Specific Indications.—Taeniacide and taeniafuge for the destruction and expulsion of tapeworm.
Action.—Pomegranate preparations, in large doses, causes nausea and vomiting, flatulence and intestinal pain. Notwithstanding the large amount of tannin it contains, such action is frequently followed by diarrhea. Other effects are tremors, muscular weakness, and cramps in the extremities, dizziness, mental confusion, drowsiness, diplopia and mydriasis, and other ocular disturbances. The tannate kills the tapeworm easily, but has far less effect upon other intestinal parasites. The associated alkaloids, sold as pelletierine, constitute an exceedingly active combination, capable of producing paralysis of the motor nerves. The tannate, probably owing to its slow solubility, is less liable to disturb the system, but is equally effective as a taeniacide.
Therapy.—When pomegranate decoction can be retained by the stomach it is a certain specific for the destruction and expulsion of tapeworm. When this preparation cannot be used, the tannate, which is far more easily administered, may be substituted. A semi-proprietary preparation called "granatin" is a salt of pelleterine in solution, and is a very effective destroyer. It is sold ready for administration as a single dose. Locke's method of treating tapeworm is popular with Eclectic physicians. The decoction he advised is prepared as follows: Press 8 ounces of the coarse bark into a vessel and pour upon it three pints of boiling water; boil, strain, and then boil again until but one pint remains. A brisk cathartic should be given at night and a light breakfast allowed in the morning. In the middle of the forenoon four ounces of the decoction should be administered. In order that this may pass quickly into the intestines and its absorption be prevented, as far as possible, a fluidrachm of fluidextract of jalap aromatized with oil of anise or oil of cinnamon should be given with the dose. In two or three hours the dose should be repeated. When the bowels begin to move administer a copious enema, and remove the worm in a vessel filled with warm water so that it may float freely and not be broken. If nausea and vomiting occur upon first giving the decoction, lemon juice should be given and the recumbent position maintained.
When pelletierine preparations are administered a light milk diet in the evening is followed in the morning by a saline purge, and then the combined alkaloids administered. In about one hour another dose of the purgative should be given. Epsom salt, fluidextract of jalap, or castor oil may be used as the cathartic. If the tannate is employed it may be administered in capsule.
