Contribution to the Pharmacy of the Pomegranate.
BY LOUIS SIEBOLD.
Read before the British Pharmaceutical Conference.
The great value of the root-bark of Punica Granatum as a remedy for tapeworm is so well established as to need no comment. It is well known, however, that the administration of this drug often results in failure on account of the extremely nauseous astringent taste of its decoction and its consequent rejection by the stomach, a fact which renders it almost useless for ladies and children. The usual way of meeting similar objections in other cases, by substituting the active principles for the crude drug, does not seem to promise well in this instance, owing to the difficulties attending the isolation of these principles in a pure state and their proneness to decomposition (see C. Tanret's researches on pelletierine and the other alkaloids of the pomegranate, abstracted in the "Year-Book of Pharmacy," 1878, p. 43; 1879, p. 38; and 1880, p. 64.) The question then arises, whether it is possible to produce, by a comparatively simple process, a pharmaceutical preparation of this bark, which, while possessing the full activity of the drug, is at the same time free from the nauseous taste and the unpleasant effects alluded to. Such a preparation, I believe I have succeeded in making. I do not wish to trouble the meeting with the various steps taken in working out the problem, nor with particulars of unsuccessful experiments in the direction indicated, but will at once lay before you the details of the process finally adopted.
Six ounces of the coarsely powered root-bank are digested three successive times with 48 fluidounces of water at 160° F., previously acidified with a few drops of acetic acid, each time for about twelve hours, during which the mixture should be frequently agitated and the temperature maintained at or near the point given. The strained infusions, measuring in all nearly 140 fluidounces, are united, and gradually mixed with solution of sugar of lead until no further precipitate is formed on testing filtered portions; the whole is then filtered, the slight excess of lead removed from the filtrate by a current of washed sulphuretted hydrogen, the mixture warmed for some time to expel the excess of the gas and again filtered, and the perfectly clear liquor evaporated on a water-bath to the consistence of a syrup, at a temperature not exceeding 140°F. Evaporation in vacua would probably be better still; but this I have not tried. Finally the small quantity of residue left is mixed with syrup of orange peel sufficient to produce a draught of about 2 fluidounces. This draught represents a dose for an adult, and should be taken at once, first thing in the morning, the patient abstaining from food and keeping quiet for about four hours after the administration. A diet of meat and fish, without bread or farinaceous food of any kind, should be observed for the two days preceding the cure, and on the last day no food whatever should be taken after dinner. During this afternoon it is also advisable to clear the bowels by means of a mild purgative; if then the draught be taken at about two or three o'clock the following morning and sleep again resorted to after its administration, the patient will have done all he can to ensure success.
In eight out of nine cases in which the efficacy of this preparation was tested, the entire tapeworm was expelled within five hours after the consumption of the draught, and in one case only success was not complete. The eight cases comprise three of Taenia solium, and five of T. mediocannellata. In one of the latter instances not the slightest care as regards diet was observed, and, contrary to all instructions, the patient took a heavy supper the night before the administration of the draught, and yet the entire worm was expelled. In all the eight cases, various tapeworm remedies had been tried previously, decoction of pomegranate root-bark being also among those employed without success, the head of the worm remaining, although the decoction in the cases alluded to was retained by the patient. It would thus appear that the preparation I have described, in addition to being free from all objectionable taste, may also be superior to the decoction of the bark in point of activity, owing, probably, to the entire absence of astringent principles, the abundant presence of which in the decoction is not unlikely to counteract the effect of the anthelmintic constituents.
The preparation obtained as above has a pleasant fruity flavor and is readily borne by the stomach. The most fastidious patient would take it without the slightest difficulty. The value of such a preparation appears to me the greater from the fact that all tapeworm remedies of repute share the nauseous taste and sickening effects of the decoction of pomegranate bark.
While admitting that the cases in which this new preparation has thus far been put to the test are yet not great in number, I think I am justified by the results in inviting the best attention of medical practitioners on the one hand, and of pharmacists on the other, to this subject. Those who are fully acquainted with the numerous failures in the treatment of cases of tapeworm by even the most renowned remedies, must long since have felt the want of a preparation combining efficacy with freedom from all unpleasant taste.—Phar. Jour. Trans., November 17, 1883.