Cephaëlis Ipecacuanha. Ipecacuanha.
Nat. Ord. — Cinchonaceae. Sex. Syst. — Pentandria Monogynia.
Description. — Cephaelis Ipecacuanha is a small shrubby plant, with a perennial root, descending obliquely into the ground, from four to six inches long, about as thick as a goosequill, simple, or divided into a few divergent branches, marked with annular rugae, flexuose, contorted, epidermous, glabrous, of a pale-brown color in the recent root, and umber or blackish-brown in the dry ; the cortex is soft, white, and subamylaceous in the fresh root, and pale-reddish, or rose-colored in the dried state, of a shining and resinous fracture, and readily separable from a central woody axis. The stem is suffruticose, from two to three feet long, ascending, often rooting near the ground, smooth and cinereous at the base, downy and green near the apex. The leaves are rarely more than four or six on a stem, oblong-ovate, acute, roughish with hairs, from three to four inches long, and from one to two broad; those at the top of the stem are opposite, and those toward the base alternate. Petioles short, downy. Stipules erect, appressed, membranous, deciduous, four to six cleft. Peduncles solitary, axillary, downy, erect when in flower, reflexed when in fruit, about one inch and a half long. Flowers small, white, in semiglobose heads, of eight, twelve or more ; involucre one-leafed, spreading, deeply four to six-parted, with obovate acuminate, ciliated segments. Bracts to each flower one, obovate-oblong, acute, downy. Calyx minute, obovate ; whitish, adhering to the ovary, with five-bluntish, short teeth. Corolla white, funnel-shaped ; tube cylindrical, downy on the outside and at the orifice ; limb shorter than the tube, with five ovate reflexed segments. Stamens five; filaments filiform, white, smooth ; anthers linear, longer than the filaments, projecting a little beyond the corolla. Ovary with a fleshy disk at the apex; style filiform; stigmas two, linear. Berry ovate, obtuse, about the size of a kidney-bean, at first purple, subsequently violet-black, two-celled, two-seeded, with a longitudinal fleshy partition. Nucules plano-convex, furrowed on the flat side.
History. — This is a small, scrubby, perennial plant, found in the moist shady woods of Brazil, and other sections of South America, but mostly between the eighth and twentieth degree of south latitude. It flowers in January and February, and ripens its fruit in May. The root, which is the officinal part, is collected during the flowering season by the Indians, who after plucking it from the ground, separate it from the stem, clean it, and hang it up in small parcels in the sun for the purpose of drying. It is principally imported from Rio Janeiro, Bahia, and Pernambuco, in large bags or bales.
As imported into this country, ipecacuanha is in pieces two or three lines in thickness, contorted, simple or branched, tapering from the center toward both ends, irregular rings or rugae, separated by narrow fissures frequently extending nearly down to the central fiber. The internal meditullium or woody part is slender, and light straw-colored ; the cortex or bark is hard, horny, translucent, breaking with a resinous fracture, and easily separating from the central ligneous cord. It is not very readily pulverized, and is the most active part of the root. Pharmacologists have divided ipecacuanha into three varieties, the grayish-black, the grayish-red, and the grayish-white, which are so named from the relative color of the surface of the roots. But as they are derived from the same plant, and are essentially the same in properties and composition, the division is of no practical utility, especially as they are received into this country often so intermingled, as to render a separation of them almost impossible.
Ipecacuanha root is seldom seen by the druggist or practitioner of this country, except in powder, from which circumstance it is much liable to adulteration. The powder of the genuine article is of a grayish-yellow color, with a faint, bitterish, obscurely acrid taste, and a weak, musty, peculiar odor, which becomes stronger and nauseating during the process of pulverization ; in some persons it excites violent sneezing, in others a difficulty of breathing resembling asthma. It yields its properties to water, and still better to alcohol, spirits or wines. Boiling impairs its virtues. The bark of the grayish-black, or dark-brown variety, consists of an odorous concrete oil, wax, gum, starch, lignin, and emetia. The woody part contains but little emetia. The grayish-black variety is supposed to contain more emetia than the grayish-red.
Emetia or emetine which is the active principle of the root, is prepared by removing the odorous fatty matter from the powder with ether, then exhausting the residue with boiling alcohol, then evaporating the alcoholic solution to dryness, and finally subjecting the extract to the action of cold water, which dissolves the emetia with some free acid, and leaves the wax and other matters. To separate the acid, and obtain pure emetia, treat the watery solution with magnesia, filter, and evaporate. The salt is thus decomposed, and the organic alkali being insoluble is precipitated with the excess of the magnesia. This precipitate is then to be washed with cold water, and digested in alcohol, which dissolves the emetia ; finally the alcoholic solution is evaporated, the residue redissolved in a dilute acid, decolorizing the solution with animal charcoal, and precipitating the emetia by magnesia. Or it may be obtained by treating the powdered root with very dilute sulphuric acid, precipitating with magnesia, and treating the precipitate in the manner above directed.
Pure emetia is whitish, without odor, very slightly bitter, pulverulent, permanent in the air, uncrystallizable, fusible at about 120°, decidedly alkaline, sparingly soluble in cold water and ether, more soluble in hot water, and very soluble in alcohol. It contains nitrogen among its constituents. With acids it forms neutral, soluble, bitter, acrid, and for the most part, uncrystallizable salts, whose solutions are precipitated by gallic and tannic acids. It is supposed to consist of 35 equivalents of carbon, 25 of hydrogen, 9 of oxygen, and 1 of azote, (C35 H25 O9 N). The root furnishes but a very small proportion of pure emetia.
Tannin, all astringents containing tannin or gallic acid, iodine, salts of iron, and acetate of lead, are incompatible with ipecacuanha.
Properties and Uses. — Emetic in large doses ; nauseant and expectorant in smaller ; and in still smaller doses, tonic, stimulant, carminative and diaphoretic. Some authors suppose it to possess narcotic properties. Given in scruple doses, it operates as an active emetic, causing much nausea, continued muscular straining, with a free secretion of mucus; vomiting, however, seldom takes place, until fifteen or twenty minutes after its administration. It is inferior to no other emetic, being safe even in large doses, seldom producing painful spasms of the stomach or bowels, and causing less prostration of the vital forces than tartar-emetic ; it is best employed in combination with other emetics, as in the Compound Powder of Lobelia, which is much used among Eclectics, and is preferred to any other emetic in the early stage of febrile diseases, and in other instances where a severe succussion of the system is indicated. In spasmodic asthma, hysteria, pertussis, sore-throat, common catarrh, and stricture of the chest common in phthisis, ipecacuanha as an emetic will be found very beneficial. In menorrhagia, a scruple of the powder at bedtime followed by a saline cathartic in the morning, has, in the hands of several practitioners, promptly checked the discharge. In fevers and inflammatory affections, small diaphoretic doses have been highly beneficial. It will likewise act as a nauseant sedative in all local inflammatory diseases, for which purpose it may be extensively used, and will be found extremely valuable in peritonitis, even the worst form occurring in puerperal women, in pneumonia, in which it will assist expectoration, also in hemorrhages, especially uterine hemorrhages. From three to ten grains will produce nausea, which may be continued for any length of time, and which is attended with more or less depression of the pulse, languor, moisture of the skin, and an increased mucus discharge from all the mucous tissues of the system, which renders it very useful in pulmonary and hepatic diseases.
In doses of one quarter of a grain to one-half, it acts as a tonic, improving digestion, increasing the appetite, and is valuable in some forms of dyspepsia. In doses of half a grain to two grains, administered every three or four hours, it produces perspiration, and is beneficial in febrile and inflammatory diseases ; combined with opium, its diaphoretic influence is greatly augmented, as seen in the Powder of Ipecacuanha and Opium. In diarrhea and dysentery, both acute and chronic, it has been regarded as a valuable remedy, free vomiting being first induced, after which, two or three grains, with occasionally one-eighth of a grain of sulphate of morphia, may be given every four hours. Combined with podophyllin, it increases the activity of that resinoid, and induces perspiration. An excellent remedy for dysentery is, one grain each of leptandrin and ipecacuanha, and half a grain of podophyllin, to be given every three hours until it operates freely. Sometimes ipecacuanha may be advantageously combined with other emetic agents, as bloodroot, lobelia, etc., to render emesis more prompt, certain, and effectual. In all cases where this drug cannot, be given by the mouth, it may be used in injection, adding two drachms of the powder to one pint of warm water, for an adult, — it will operate kindly and thoroughly as an emetic.
Recently, a liniment of ipecacuanha has been introduced into practice, for the treatment of incipient phthisis, certain rheumatic affections, chronic hydrocephalus, chronic inflammation of the synovial membrane of the knee, and infantile convulsions. As soon as the pustular eruption appears, the symptoms improve more or less rapidly, until a cure is effected. It is made of powdered ipecacuanha, sweet oil, of each, two drachms, lard half an ounce ; mix them well together. To be rubbed into the part affected, fifteen or twenty minutes at a time, and to be repeated three or four times daily, covering the part after each rubbing with flannel ; in from 24 to 48 hours the eruption appears. It is stated, that an infusion of two drachms of ipecacuanha in a gill of hot water, and strained, will, if drank warm, prove emetic ; then if the same quantity of hot water is again added to the residue, strained, and drank cold, it will prove purgative ; and the same process repeated the third time, and used cold, becomes a valuable tonic.
Emetia, the active principle of this drug, is so severe and uncertain in its action, that it is not used in medicine. Two grains of it will kill a large dog. A sixteenth of a grain vomited an old man severely.
Off. Prep. — Pulvis Ipecacuanhae Compositus ; Pulvis Ipecacuanha et Opii ; Tinctura Serpentariae Composita; Unguentum Ipecacuanhae; Vinum Ipecacuanhae.