Cascara Sagrada.

Botanical name: 

Related entry: Rhamnus californica- Rhamnus frangula

The dried bark of Rhamnus Purshiana, De Candolle (Nat. Ord. Rhamnaceae). A shrub of Northern Idaho and the Pacific coast. Dose, 5 to 30 grains.
Common Names: Sacred Bark, Chittem Bark.

Principal Constituents.—Several resins, a volatile oil, and cascarin, a glucoside thought to be identical with frangulin obtained from Frangula.
Preparations.—1. Specific Medicine Cascara. Dose, 15 to 60 drops.
2. Extractum Cascarae Sagradae, Extract of Cascara Sagrada. Dose, 4 to 8 grains.
3. Fluidextractum Cascarae Sagradae, Fluidextract of Cascara Sagrada. Dose, 10 to 60 minims.
4. Fluidextractum Cascarae Sagradae Aromaticum, Aromatic Fluidextract of Cascara Sagrada. Dose, 10 to 60 minims.
Specific Indications.—Constipation due to neglect or to nervous and muscular atony of the bowels; minor ailments, dependent solely upon constipation, with intestinal atony.

Action and Therapy.—Cascara is a simple and practically non-griping purgative, acting with but little or no prostration and never causing a watery stool. It has, moreover, a tonic action upon the stomach and bowels, and does not produce an after constipation. It is the most popular and most efficient agent for chronic constipation, and may be given for a considerable time without increase of dosage. In fact, the dose may be gradually decreased from day to day often with the result of completely curing the constipation. Cascara is adapted to cases of atony of the intestines. When other simple ailments depend upon constipation they may often be remedied-by cascara. It is an efficient purgative in pregnancy, in hemorrhoids with loss of rectal tone, in atonic dyspepsia with costiveness, and in sick headache due to atonic sluggishness of the bowels. Gastric and duodenal catarrh, with jaundice, are often rectified by cascara, and it has given good results in chronic diarrhea when accompanied by hepatic torpor.

Only preparations of old cascara bark are desirable; the fresh bark is emetic and otherwise disturbing. The taste of cascara is extremely bitter. This may be modified to a large degree by the addition of fluidextract of licorice and spirits of anise and sassafras. The aromatic fluidextract is a pleasant preparation and has less of a tendency to cause griping. A good laxative is the following: Rx Specific Medicine Cascara (or the Fluidextract of Cascara), 2 fluidounces; Fluidextract of Licorice, ½ fluidounce; Essence of Anise, 1 drachm; Simple Syrup, to make 6 fluidounces. Dose: One half to one teaspoonful at bedtime. If a more profound action is desired a half drachm of Specific Medicine Podophyllum may be added.

The Eclectic Materia Medica, Pharmacology and Therapeutics, 1922, was written by Harvey Wickes Felter, M.D.