Colocynthis (U. S. P.)—Colocynth.

Fig. 81. Fruit of Citrullus Colocynthis. Preparations: Extract of Colocynth - Compound Extract of Colocynth - Compound Pills of Colocynth
Related entry: Pepo (U. S. P.)—Pumpkin Seed

"The fruit of Citrullus Colocynthis, Schrader, deprived of its rind"—(U. S. P). (Cucumis Colocynthis, Linné; Colocynthis officinarum, Schrader).
Nat. Ord.—Cucurbitaceae.
COMMON NAMES: Bitter apple, Bitter cucumber, Colocynth pulp.
ILLUSTRATIONS: Köhler's Medizinal-Pflanzen, Vol. I, Plate 118; Bentley and Trimen, Med. Plants, 114.

Botanical Source.—Colocynth is an annual plant, with a whitish root, and prostrate, angular, hispid stems. The leaves are alternate, cordate, ovate, many-lobed, and white, with hairs beneath; the lobes obtuse; the petioles as long as the lamina. The tendrils are short. The flowers axillary, yellow, solitary, and stalked; the females, with tube of the calyx globose, Somewhat hispid, and the limb campanulate, with narrow segments. The petals are small. The fruit is globose, smooth, the size of an orange, and yellow when ripe, with a thin, solid rind, and very bitter flesh.

History.—The bitter apple, or cucumber, is a native of Northern Africa (overrunning the sandy spots of Nubia and Upper Egypt after the rainy period), the Cape of Good Hope, Western Asia, Japan, etc., and is cultivated in Italy and Spain. The fruit assumes a yellow or orange color externally during the autumn, at which time it is collected, and dried quickly, either in a stove or in the sun, after which it is peeled. The colocynth with which the United States is supplied, is chiefly derived from the Mediterranean ports. That which is deprived of its rind, and is very white, light, and spongy, is considered the best article; and the grayish or brownish drug, owing to careless curing, is of the poorest quality. The fruit, as usually met in commerce, is about the size of a small orange, or more generally in broken apples or fragments of the drug devoid of seeds. Occasionally the drug is found with the brown, dried rind intact. A Persian colocynth occurs in the London markets, having a shrivelled appearance, with the seeds tightly imbedded in the pulp, owing to the fact that it has been peeled while still fresh, but the drug of commerce is usually divested of its rind after having been dried. The yellowish-brown seeds (3/10 inch long by 1/5 inch broad) are ovate, flat, and composed of a thick, hard testa, enclosing 2 oily cotyledons, and arranged on the 3 placentae so as to give the 1-celled fruit a 6-celled appearance. They have been used for food by the poorest Saharan tribes, after being deprived of all the pulp and heated by boiling, roasting, or baking (Flückiger). A paste of the root and fruit is used locally on pimples and boils, and the root (paste), is spread upon enlarged bellies in children, and for rheumatic complaints the root, combined with an equal quantity of long pepper, is administered in pill form in (the Concan) India (Dymock).

Description.—"From 5 to 10 Cm. (2 to 4 inches) in diameter; globular; white or yellowish-white; light, spongy; readily breaking into 3 wedge-shaped pieces, each containing, near the rounded surface, many flat, ovate, brown seeds; inodorous; taste intensely bitter. The pulp only should be used, the seeds being separated and rejected"—(U. S. P.).

Chemical Composition.—Meissner, in 1818, made a chemical analysis of colocynth. He obtained the bitter principle in an impure form, and called it colocynthin. The fruit was further investigated, and various modes of isolating colocynthin were proposed by Vauquelin (1818), Braconnot (1819), Herberger (1830), Labourdais (1848), Bastick (1850), Hübschmann (1858), and Walz (1858), and again, more recently by G. Henke (Archiv. der Pharm., 1883, p. 200). According to Walz, colocynthin is a glucosid, the action of diluted acids resolving it into colocynthein, a resinous body, and sugar. Walz also describes a crystalline substance, colocynthitin, insoluble in water and cold absolute alcohol, but soluble in ether and boiling alcohol. Henke could not obtain colocynthin in crystals, which was the form claimed for it by Walz; contrary to Walz, he also found it insoluble in benzene. Henke's colocynthin is insoluble in chloroform, ether, carbon disulphide, and petroleum ether, but is soluble in water (rendering the solution very bitter), alcohol, ammonia water, and an aqueous solution of chromic acid. Tannic acid precipitates it completely from aqueous solution. From 5 kilograms of colocynth deprived of seeds, Henke obtained only 30 grams of colocynthin, and recommends the use of the drug in fresh condition. E. Johannson, in 1885, found colocynthein to be less soluble than colocynthin in water, and in acid solution soluble in benzene, which affords a means of separating it from colocynthin. Colocynthin he also found soluble in acetic ether.

Colocynth contains about 4 per cent of fatty oil which is used in India as a remedy (Jahresbericht der Pharm., 1892, p. 28). In addition to the foregoing, Mr. George Wagner (Proc. A. P. A., p. 179), examined colocynth in 1893, and (Amer. Jour. Pharm., p. 272), Prof. L. E. Sayre investigated American colocynth in 1894.

Action, Medical Uses, and Dosage.—Colocynth is irritant and cathartic. It acts very powerfully, producing copious watery evacuations. Even in moderate doses, it has excited inflammation of the mucous membrane of the intestines, vomiting, severe tormina, and bloody stools. Except in minute doses, it is never used alone, because its violence is greatly mitigated, while its efficacy and certainty are not impaired, by uniting it with other cathartics, as aloes, scammony, etc. The addition of extract of hyoscyamus will likewise deprive it of its harsh and griping effects. Its principal employment in material doses is in passive dropsy, in cerebral derangements, and in pills with other cathartics for the purpose of overcoming torpid conditions of the biliary and digestive systems. However, it is scarcely ever used for these purposes in our school to-day. Its irritant effect upon the rectum may influence the uterus by sympathy of contiguity, and thus provoke menstruation, and on the same principle, dissolved in whiskey, it has cured gonorrhoea. It has been used in moderate doses, in all diseases where catharsis is indicated. The powder applied to an ulcer, or raw surface, affects the lower bowels in the same manner as when taken internally, and the tincture applied to the abdomen has purged, and more actively when the surface has been denuded of its epidermis. It is said that Hippocrates used the colocynth apple as a pessary for the purpose of exciting menstruation. Debility and even slight gastro-intestinal inflammation contraindicate the use of colocynth. Later years have developed the true sphere of colocynth as a remedy, and that use is not as a cathartic. It is essentially a remedy for visceral pain, and the dose should be very small. Not more than 5 or 10 drops of the specific colocynth should be added to 4 ounces of water, of which the dose is a teaspoonful. Even better are the same number of drops of the 1 x dilution of the specific medicine. The pain calling for colocynth is cutting, darting, cramping, or tearing. It is of great value in stomach and intestinal disorders with sharp "belly-ache," and meets these disorders even when rheumatoid, and is particularly valuable in neuralgic pains of the viscera. The patient is cold, weak, and feels faint; the pain of a sharp character causing him to flex his body upon his thighs. The back, joints, and bones feel stiff and sore, as if bruised, and the abdominal pain is made worse by motion. It is an important remedy in dyspepsia, with bitter taste, bilious yellow and bitter eructations, and bloating after eating, accompanied with sharp griping or cutting, colic-like pain in the umbilical region. The minute dose here acts best: Rx Specific colocynth, 1 x dil., gtt. j to x; aqua, fl℥iv. Mix. Teaspoonful every 3 or 4 hours. The same characteristics indicate it in flatulent, worm, and bilious colics. The accumulation of gases may be large, producing by distension disturbances of the breathing organs and heart, with much anxiety, and belching, or expulsions of flatus may be symptoms, and nausea and vomiting are not uncommon. Cholera infantum sometimes presents many of these symptoms, and colocynth will give prompt relief. Chronic diarrhoea, with slimy stools and distended abdomen and the characteristic pain, or diarrhoea due to overeating or improper food are relieved by it. In dysentery, with cutting tormina and tenesmus and ineffectual efforts at stool, it is an admirable remedy. It should not be overlooked in liver disorders with tympanites, constipated bowels, and sharp, darting pains in the liver region; and in the chronic constipation of women and children with the symptoms above mentioned, and, in addition, dry, hard scybalous feces, its tonic action is marked and gastric and intestinal digestion improved, with a consequent improvement of the constipated state. In fact, in chronic disorders of any kind in which colocynth aids, there is an evident intestinal and hepatic inactivity. Certain forms of headache, with the colocynth pain, whether neuralgic or reflex from stomach troubles, are remedied with colocynth. It exerts a direct influence upon the nervous system, relieving neuralgia of the parts supplied by the solar plexus, neuralgic colic, ovarian neuralgia, orchialgia, neuralgia of the fifth nerve, and sciatica, all presenting the characteristic sharp, cutting pain. The same is true in rheumatic complaints and lumbago. Colocynth is decided in its action upon the female organs of reproduction. When colicky pains precede or accompany amenorrhoea, and pressure gives relief, colocynth is the remedy; other painful states of these organs are relieved when the cases are properly selected. A characteristic of colocynth is that, if it is to help at all, it helps quickly, but the smaller doses should be tried before a failure is declared. The oil of colocynth has been recommended as an external remedy for neuralgia. The dose for the old cathartic use of colocynth is from 4 to 10 grains, either in powder or aqueous extract; of the alcoholic extract, from 1 to 4 grains. When to be given alone, it should be triturated with some inert or insoluble powders, as gum or farinaceous matter, in order to diminish its severity of action. For the newer and specific uses of colocynth: Rx Specific colocynth (or 1 x dil.), gtt. j to x, aqua, fl℥iv. Mix. Dose, a teaspoonful every 1 to 4 hours.

Specific Indications and Uses.—Pain of a cutting, twisting, boring, griping, contractive character, and if of the gastro-intestinal tract, accompanied with a desire to go to stool; colicky pains in the umbilical, iliac, and hypogastric regions; dysentery, with tormina in right iliac region or diffused over the abdomen; diarrhoea, with shining, mucoid passages, and tenesmic, colicky pain; constipation, with dry scybalae and sharp, griping pain in the lower bowel; flatulent eructations and discharges; tensive rheumatic pain, with contractions; visceral neuralgia of cutting character.

Related Species.Cucumis trigonus, Roxburgh (Cucumis Pseudo-colocynthis, Royle); Karit.—North India, especially the presidency of Bombay. The fruit is exceedingly bitter, and resembles a small egg streaked with yellow and green. It is carried into market during the Hindu New Year feast. At this time the Bombay Hindus are accustomed to crush a gourd with the foot, touch the forehead and tongue with it, thus, of their own accord, tasting bitter, hoping thereby to be protected and preserved from calamities throughout that year. It is employed medicinally, but not for food. A variety, (var. pubescens), not so bitter, after soaking in salt water, is eaten like the cucumber, and the seeds are employed in herpes (see Dymock, Mat. Medica Western India).

Cucumis Hardwickii, Royle; Hill colocynth of India.—Purgative.

Cucumis prophetarum, Linnaeus.—Arabia. Purgative.

Luffa operculata, Cogn.—Brazil. The drastic fruit of this plant has been employed in affections for which colocynth is used. The boiled fruit pulp is strained, beaten into froth, and, when cold, given in tablespoonful doses for dropsical complaints until either purging or vomiting, is induced. It is quite a popular domestic remedy in its native habitat (Amer. Jour. Pharm., Vol. 56). For Luffa echinata, Roxburgh and its constituents, see Amer. Jour. Pharm., 1888, p. 486.

Luffa acutangula var. amara, Roxburgh.—The Karvi-turai of the Hindus who employ the fruit and vine medicinally. It possesses cathartic and emetic properties for which purposes the infusion of the ripe seeds is generally preferred. The juice of the fruit is employed locally for headache and bites. The bitter leaves are employed in Bombay for sores upon cattle (Dymock, Mat. Med. Western India).

Cucumis myriocarpus.—The Cacur of southern Africa. Has active emeto-cathartic propertics, similar to those of colocynth, and, after heating, is used by the natives for its emetic action. It contains a neutral, resinous substance (myriocarpin) which is also emeto-cathartic.

CAYAPONINE.—The alkaloid extracted by Gubler from Cayaponia globulosa (Nat. Ord.—Cucurbitaceae), of Brazil. In doses of 1/10 grain it is said to purge without pain.

King's American Dispensatory, 1898, was written by Harvey Wickes Felter, M.D., and John Uri Lloyd, Phr. M., Ph. D.