Cypripedium (U. S. P.)—Cypripedium.

Preparations: Oleoresin of Cypripedium - Extract of Cypripedium - Fluid Extract of Cypripedium - Compound Powder of Yellow Ladies'-Slipper
(The Cypripediums are rare and endangered orchids. Don't use them unless you grow them yourself. -Henriette)

The rhizome and roots of Cypripedium pubescens, Swartz, and of Cypripedium parviflorum, Salisbury"—(U. S. P.).
Nat. Ord.—Orchideae.
COMMON NAMES: Ladies'-slipper, Yellow ladies'-slipper, American valerian, Umbel, Nerve-root, Yellow moccasin-flower, Noah's ark.
ILLUSTRATION: Johnson's Med. Bot. of N. A., Plate VIII (Cyp. pub.).

Botanical Source.—Cypripedium pubescens is an indigenous plant whose roots are perennial, fibrous, fleshy, undulated, or crooked, long, about a line in diameter, from which arise one or several round, leafy stems, growing from 12 to 18 inches high. The leaves are from 3 to 6 inches long, by 2 or 3 broad, sheathing, oblong-lanceolate, entire, veined, cauline, acuminate, pubescent, alternate, and generally the same number on each side. Its flowers are large, very showy, terminal, and solitary. Segments 4. Lobe of the style triangular-oblong, and obtuse; the sepals ovate, oblong, and acuminate; the petals long, linear, and contorted; the lip shorter than the other petals, compressed laterally, very convex, and gibbous above, pale-yellow, and from 1 ½ to 2 inches long (B.—R.—W.).

Cypripedium parviflorum has been considered a distinct species by some botanists, and as a mere variety by others. It differs from the above in having the lobe of the style acute, the leaves are broader, the flowers somewhat smaller, and the perianth more brownish-purple in color (W.).

History.—This plant is found in most parts of the United States, in rich woods and meadows, flowering in May and June; its flowers are scentless. There are several varieties of it, all of which possess similar virtues, and the roots of which are undoubtedly collected, sold, and indiscriminately used with the official article (see Related Species).

The rhizomes and fibrous roots of these plants are the parts used in medicine. They should be gathered in autumn, cleansed from dirt, and carefully dried in the shade. They have a peculiar, slightly bitter, and rather nauseous taste, and a somewhat unpleasant odor. Alcohol, or boiling water, takes up their virtues, which, however, are impaired by boiling.

Description.—"Of horizontal growth, bent, 10 Cm. (4 inches), or less, long; from 3 to 5 Mm. (1/10 to ⅕ inch) thick; on the upper side beset with numerous circular, cup-shaped scars; closely covered below with simple, wiry roots, varying from 10 to 15 Cm. (4 to 6 inches) in length; brittle, dark-brown, or orange-brown; fracture short, white; odor peculiar, heavy; taste sweetish, bitter, and somewhat pungent"—(U. S. P.).

Chemical Composition.—Mr. H. C. Blair (1866) found the root of Cypripedium pubescens to contain a volatile oil, a volatile acid, tannin, gallic acid, two resins, gum, glucose, starch, and ligneous matter; and salts of calcium, potassium, and magnesium. A more recent quantitative analysis by E. S. Beshore (Amer. Jour. Pharm., 1887, p. 395) confirms these results, except that the tannic principle is distinct from both tannic and gallic acids. Alkaloids were not present, except a weak basic, substance obtained in distilling the drug with milk of lime.

CYPRIPEDIN, an impure active principle, oleoresin-like, and incorrectly named cypripedin, has been procured from the root by a process similar to that named for oleoresins of iris, xanthoxylum, etc. It may be given in doses of from ½ to 2 or even 3 grains, but is inferior to other preparations.

Action, Medical Uses, and Dosage.—Tonic, stimulant, diaphoretic, and antispasmodic. Its chief value is as a nerve stimulant in atonic cases, improving both the circulation and nutrition of the nerve centers (Scudder). It is not a powerful agent. This root is valuable in all cases of nervous excitability or irritability unconnected with organic lesions, allaying the irritability, lessening any accompanying pain, producing a more calm and cheerful condition of the body and mind, and consequently favoring mental tranquillity, or sleep. Hence it has been of service in hysteria, chorea, nervous headache, wakefulness and prostration in low fevers, epilepsy, from reflex irritation, and, indeed, in all cases of morbid irritability of the nervous system, from functional derangement or reflex irritation. It will be found very efficient in the nervousness, hypochondria, or mental depression accompanying certain forms of derangement of the digestive organs, which is more generally met with among females. Its action is greatly increased when combined with certain other agents, though this is not always necessary or advisable; thus, combined with Eupatorium aromatica and Scutellaria lateriflora, it has proved beneficial in neuralgia, delirium, and hypochondria. A soothing syrup for nervous irritation of children is recommended by Prof. Scudder (Spec. Med.): Rx Specific cypripedium, compound tincture lavender, aa flʒii; specific lobelia, fl℥j; simple syrup, fl℥iii. Mix. The alcoholic extract is a good form of administration.

The following preparation has been used in sick or nervous headache, not dependent on acid stomach: Take of Nepeta cataria, Scutellaria lateriflora, and Cypripedium pubescens in powder, of each, ½ ounce, pour on a pint of boiling water, and infuse for 15 or 20 minutes. Dose, 1 fluidounce of the warm infusion, after which, ½ fluid ounce, every ½ hour, for 3 or 4 hours, or until the headache ceases. Used thus, during 3 or 4 attacks of headache, it is asserted to have invariably effected permanent cures of this distressing complaint. An infusion is said to be beneficial in the pains of the joints following scarlet fever. Although considered by many practitioners superior to valerian, yet it will be found inefficient in many instances where the European article will prove beneficial. Prof. D. T. MacDougal (Amer. Jour. Pharm., 1896, p. 218), points out that the leaves and stems of Cypripedium spectabile and C. pubescens exert a poisonous influence upon the human skin, and that the source of this property resides in the glandular hairs with which the plant is covered. Dose of alcoholic extract, from 10 to 20 grains; tincture, from 1 to 3 fluid drachms; infusion, from 1 to 4 fluid ounces; of the powder, 1 drachm in warm water, repeated as required; specific cypripedium, 10 to 60 drops.

Specific Indications and Uses.—Insomnia, nervous irritability, neuralgia, and delirium, all from atony; menstrual irregularities, with despondency; tendency to dementia at climacteric; mental depression from sexual abuse.

Related Species.—The following species of Cypripedium possess properties analogous to those of the official drug:

Cypripedium spectabile, Willdenow; Showy ladies'-slipper.—Having crowded, ovate-lanceolate leaves, embracing each other; lobe of the style elliptic-cordate, obtuse; sepals broad-ovate, obtuse; lip longer than the petals, cleft before, white striped with purple, 2 inches long, 1 ½ inches broad; flowers very large, 2 or 3 on each plant, appearing in May and June. The whole plant pubescent (W.).

Cypripedium acaule, Aiton; Low or Stemless ladies'-slipper.—Having a bulbous root with numerous fleshy fibers; scape leafless, 1-flowered; leaves radical, in pairs, oblong, obtuse; lobe of the style round-rhomboid, acuminate, deflexed; lip longer than the lanceolate petals, cleft before, purple, or white, nearly 2 inches long, veiny; flowers solitary, terminal, with a single, lanceolate bract at the base, and appearing in May and June (W.—B.—R.).

Cypripedium candidum, Willdenow; Small white, or White-flowered ladies'-slipper.—Having a leafy stem, oblong-lanceolate leaves; lobe of the style lanceolate, somewhat obtuse; lip rather shorter than the lance-linear petals, white, about ¾ of an inch long; flowers terminal, solitary. The plant is slightly pubescent, seldom growing above a foot in height; the flowers appear in May and June (W.).

Cypripedium arietinum, Aiton, or Ram's-head ladies'-slipper.—Having a leafy stem; elliptical, striate-veined, sessile, amplexicaul leaves; lobe of the style orbicular, somewhat obtuse; lip as long as the petals, saccate, obconic before, red, and white-veined, hairy at the orifice, about ½ inch long; perianth greenish-brown. The flowers are mostly solitary with a leafy bract at base, and appear in May and June (W.—B.—R.).

Cypripedium spectabile and Cypripedium acaule are said to possess more narcotic properties than the others, especially when inhabiting dark swamps.

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