Extractum Leptandrae (U. S. P.)—Extract of Leptandra.
Preparation.—"Leptandra, in No. 40 powder, one thousand grammes (1000 Gm.) [2 lbs. av., 3 ozs., 120 grs.]; alcohol, water, each, a sufficient quantity. Mix seven hundred and fifty cubic centimeters (750 Cc.) [25 fl℥, 173♏] of alcohol with two hundred and fifty cubic centimeters (250 Cc.) [8 fl℥, 218♏] of water, and, having moistened the powder with four hundred cubic centimeters (400 Cc.) [13 fl℥, 252♏] of the mixture, pack it firmly in a cylindrical percolator; then add enough menstruum to saturate the powder and leave a stratum above it. When the liquid begins to drop from the percolator, close the lower orifice, and, having closely covered the percolator, macerate for 48 hours. Then allow the percolation to proceed, gradually adding menstruum, using the same proportions of alcohol and water as before, until the leptandra is exhausted. Distill off the alcohol from the tincture by means of a water-bath, and evaporate the residue, oil a water-bath, to a pilular consistence"—(U. S. P.).
Description and History.—This is a blackish-brown extract, partially dissolving in water, a deep-brown, bitter solution resulting. (For remarks concerning Leptandrin and Extract of Leptandra, see Leptandra).
Medical Uses and Dosage.—Extract of Leptandra is a powerful cholagogue, with but slight laxative influence; except given in very large doses its cathartic powers are but very feeble. It is one of the most efficient and important agents among those of American origin, being the only known medicine that efficiently stimulates and corrects the hepatic secretions and functional derangements of the liver, without debilitating the system by copious alvine evacuations. It may be safely and efficiently employed in the treatment of diarrhoea, cholera infantum, some forms of dyspepsia, typhoid fever, and all diseases connected with biliary derangements. Combined with resin of podophyllum it is a prompt and effectual remedy in epidemic dysentery, often effecting a permanent cure in from 12 to 18 hours; in dysentery, with irritable bowels, it may be used alone with advantage, or combined with camphor, as in such cases its union with resin of podophyllum is contraindicated. In intermittents it renders the action of quinine, when united with it, more certain, and prevents the liability to a return of the disease, at least for the season, and is likewise highly beneficial in infantile remittent fever, and in periodic diseases generally, of an obstinate character, in which quinine alone seems to produce little or no result. It may also be used in many other combinations with much advantage, as with hydrochlorate of berberine, or dried ox-gall, in some dyspeptic affections, jaundice, piles, etc., or with oleoresin of blue flag, extract of wild indigo, extract of poke, extract of turkey corn, resin of blue cohosh, and other active principles, in various forms of disease. Dose of extract of leptandra, from ½ to 5, 6, or 7 grains, every 3 or 4 hours, according to the action or effect desired. Some practitioners neglect the use of this agent, because it does not act so powerfully as resin of podophyllum, and hence lose the influence of a very important remedy in functional derangements of the liver, and other organs essential to digestion. The above remarks refer to both the ordinary extract and the dried extract, heretofore known as "Leptandrin" (King). In relation to the dried extract (leptandrin) Prof. Hill observes, and which observations will apply with equal force to the ordinary extract:
"This is not, strictly speaking, a cathartic. It is aperient, alterative, and tonic. Its effects on the liver are peculiar. In cases of children afflicted with summer complaint, where there is evidently a lack of the proper biliary secretion, but where, owing to the already irritated condition of the bowels, the ordinary medicines for arousing the liver are inadmissible, this article seems to be the very thing needed. While it acts freely upon the liver, instead of purging, it seems only to change the discharges from the light and watery or slimy condition, to a darker and apparently bilious state, rendering them more and more consistent, until they become perfectly natural, without having been arrested entirely, or at any time aggravated. It at the same time seems to act as a tonic, restoring the tone of the stomach and increasing the strength and activity of digestion. It is a most valuable remedy in dyspepsia.
"The dose is from ¼ to 1 grain every 1 or 2 hours in acute cases, and from 1 to 2 grains, 3 times a day, in chronic cases. It is valuable to combine with resin of podophyllum as a remedy in dyspepsia and chronic hepatitis.
"In the epidemic dysentery, which has prevailed for the past two seasons in many parts of our country, this article has been of great service. It was usually given with the best success after evacuating the bowels freely, with a combination of resin of podophyllum and dried extract of leptandra or rhubarb. (I have omitted the old incorrect names of leptandrin and podophyllin, in the original, and substituted the correct ones [King]). For this purpose, give from ½ to 1 grain every hour, gradually lengthening the intervals as the discharges become darker. Though it may not be applicable in all cases of dysentery, it is doubtless one of the most useful articles in this dangerous disease."
In cholera infantum, a disease which sometimes sets at defiance all the skill of the physician, Prof. King met with excellent success with the following combination: Take of dried extract of leptandra, 6 grains; quinine, 3 grains; camphor, 1 ½ grains; ipecacuanha, ¾ grain. Mix and divide into 12 powders of which 1 may be given every 2 or 3 hours, and its use continued thus for several days. Its action at first is to increase the alvine passages and apparently augment the disease, but in a few days the character of the evacuations changes, they become more and more normal, as well as more regular in their appearance; after which, 1 or 2 powders per day for a week, will render the cure permanent. This powder, in large doses for adults, will be found very efficient in painful diarrhoea and dysentery, as well as in severe pains depending upon intestinal irritation. The following has also been of advantage in cholera infantum: Triturate together, charcoal 1 drachm, with dried extract of leptandra 3 grains, and divide into 12 powders, of which 1 powder is to be given every 2 or 3 hours until the evacuations become more natural, after which, give 1 or 2 powders a day for a few days.
Extract of leptandra will be found to act with more certainty when it is given in a soluble form, as in tincture, weak solution of potassa, etc. Like hydrochlorate of berberine, and other concentrated preparations which are insoluble in water, it frequently passes through the alimentary canal unchanged, when given in the form of powder.