Rhamnus Purshiana (U. S. P.)—Cascara Sagrada.

Fig. 207. Geniune Cascara sagrada. Photo: Frangula purshiana 1. Preparations: Fluid Extract of Rhamnus Purshiana - Aromatic Fluid Extract of Rhamnus Purshiana - Extract of Cascara Sagrada
Related entries: Rhamnus cathartica.—Buckthorn - Frangula (U. S. P.)—Frangula

The bark of Rhamnus Purshiana, De Candolle (Rhamnus alnifolius, Pursh; Frangula Purshiana, Cooper).
Nat. Ord.—Rhamnaceae.
COMMON NAMES: Chittem bark, Sacred bark.
ILLUSTRATION: Hooker, Flora Bor. Amer., Vol. I, Plate 43.

Botanical Source and History.—This is a small tree, found in the Rocky Mountains, and westwardly to the Pacific Ocean, and extending north into British America. According to Mr. James G. Steele, the country producing the tree extends over 1000 miles in length. The branches are round and pubescent. The leaves are from 3 to 5 inches long, about one-half as broad, and are borne on leaf-stalks nearly an inch in length. When young they are covered with a dense pubescence on the under surface, but become glabrous and bright-green when old. In outline, they are broadly elliptical, obtuse, and entire at the base, and generally with a blunt, acute apex. The margin of the leaf is regularly dentate, with numerous small, serrate teeth, except at the base. The lateral veins are many, subparallel, prominent underneath, and proceed from the midrib at an acute angle. The leaves closely resemble, but are not so slender as those of the Alder buckthorn, or Southern buckthorn, of our southern States (Frangula caroliniana, Gray, or Rhamnus caroliniana, Walter). The flowers are small, white, and appear after the leaves have matured; they are borne in close, umbellar clusters, on pubescent peduncles, slightly longer than the leaf-stalks. The pedicels are short, about 1/4 inch in length when in flower, but, in fruit, elongate to an inch or more. The calyx is small, 5-cleft, and pubescent on the outer surface. The petals are 5, minute, white, shorter than the calyx lobes, and 2-cleft at the apex. The stamens are 5, opposite, and embraced by the concave petals. The pistil, which is much shorter than the calyx-tube, consists of a free, 3-celled, and 3-ovuled ovary, a short style, and a 3-lobed stigma. The fruit is a small black drupe, obtusely 3-angled, about the size of a large pea, and contains 3 black, shining seeds. The genus Rhamnus is represented by 6 native species, and all, excepting R. lanceolata, Pursh, and R. alnifolia, L'Heritier, are found on the Pacific coast. A few of the western species have evergreen coriaceous leaves. Rhamnus californica, Eschscholtz (Frangula californica, Gray), known as California buckthorn, or California coffee tree, probably furnishes a portion of the Cascara sagrada of commerce (see Related Species). The bark of California mountain holly (Rhamnus crocea) is aromatic and bitterish, and has both tonic and laxative qualities.

Cascara sagrada was discovered by an Eclectic physician, Dr. J. H. Bundy, its virtues being first extolled in "New Preparations," Detroit, 1877. Parke, Davis & Co. introduced the fluid extract to the medical profession and gave it great conspicuity. It may be confidently said that to their efforts is due the widespread celebrity of this drug and its preparations.

Description.—The bark is the part used in medicine, and has long been known in domestic practice among western people as a mild cathartic. Cascara sagrada is officially described as "in quills or curved pieces, about 3 to 10 Cm. (1 1/5 to 4 inches) long, and about 2 Mm. (1/12 inch) thick; outer surface brownish-gray and whitish; the young bark having numerous, rather broad, pale-colored warts; inner surface yellowish to light brownish, becoming dark-brown by age; smooth or finely striate; fracture short, yellowish, in the inner layer of thick bark somewhat fibrous; inodorous; taste bitter"—(U. S. P.).

Chemical Composition.—Prof. Prescott (Amer. Jour. Pharm., 1879, p. 165) described the microscopical structure and the chemical composition of the bark, which he finds to contain: (1) A brown resin, bitter to the taste, soluble in alcohol, chloroform, benzol, and carbon disulphide; insoluble in ether; slightly soluble in water. Solution of caustic alkalies dissolve it with purple-red color, from which solution acids precipitate it. Charcoal removes it from its alcoholic solution. It occurs chiefly in the middle and inner layers of the bark. (2) A red resin, nearly tasteless, insoluble in water; slightly soluble in ether, chloroform, and carbon disulphide; soluble in alcohol, and in caustic alkali with a brown color. Animal charcoal does not remove it from its solution in alcohol. It occurs in the corky layer of the bark. (3) A light-yellow resin, neutral, tasteless, insoluble in water; soluble in hot alcohol, chloroform, and carbon disulphide; not colored by potassium hydroxide solution.

In addition, Prof. Prescott obtained a tannic acid, oxalic acid, malic acid, a yellow fixed oil, volatile oil, wax, starch, and a neutral crystallizable body. The latter substance, from solution in absolute alcohol, crystallized in the form of white, double pyramids, which were almost insoluble in ether, chloroform, and petroleum ether; soluble in benzol. They melt and sublime, unchanged, at a temperature little above the heat of a water-bath, condensing into crystalline form. The substance does not give alkaloidal reactions. Prof. Prescott believes that some of these substances are closely related to constituents of Rhamnus frangula. P. Schwabe (Archiv der Pharm., 1888, p. 591) found the bark to contain emodin (C15H10O5) (see Rhubarb), but was unable to confirm the statement of Prof. W. T. Wenzell (1886), that a crystallizable glucosid (not identical with frangulin) is present in the bark (see Frangula). A. R. L. Dohme and H. Engelhardt (Proc. Amer. Pharm. Assoc., 1897, p. 198) succeeded, however, in isolating from cascara sagrada a glucosid, which they named purshianin. Leprince, in 1892, obtained an orange-red substance, which he named cascarin (C12H10O5), and which F. L. Phipson (Comptes Rendus, 1892) believes identical with rhamnoxanthin of Buchner (see Frangula). Messrs. H. F. Meier and J. LeRoy Webber (Pharmacology of the Newer Materia Medica, Detroit, 1892) found the bark to contain a ferment, occurring especially in recent bark, and being destroyed by heat. To this principle, it is claimed, the unpleasant griping and vomiting effects of recent bark are due. The authors also state that a glucosid is present, which is not bitter, but yields a bitter principle upon hydrolysis with acids or the gastric juice. Dr. H. G. Eccles (Druggists' Circular, 1888, p. 54) reported the presence of an alkaloid in cascara bark.

Action, Medical Uses, and Dosage.—Cascara sagrada, when introduced as a medicine, was highly recommended as a certain remedy in cases of habitual constipation, and in some forms of indigestion. Further trial has substantially sustained these assertions, and it is, undoubtedly, a valuable addition to our list of therapeutical agents. It does not, however, succeed in all cases, but acts best where a tonic to the intestines is required. As it tones the whole intestinal tract, it is valuable in doses of 10 drops, after meals, for that dyspeptic condition which depends most largely upon constipation, and is due to intestinal weakness. Administered in large doses, it has served us nicely in sick headache, due to like causes. Loss of tone in the rectum, with constipation, giving rise to hemorrhoids, is benefited by it. In chronic constipation it may be necessary to begin with the larger doses, and gradually reduce the quantity to a few drops, 3 times a day, though, as a rule, it is better to give repeated small doses, gradually increased, until the desired action is obtained, and then to gradually withdraw the drug. It acts kindly without irritating or griping, and produces stools of a semifluid consistence. Occasionally, but rarely, have reports of harsh action been made, such as cramps, colic, vomiting, and inordinate catharsis, while a soreness of the bowels, persistent in character, has been attributed to it. These effects, however, are not common. The remedy, in 10 to 15-drop doses, has been used with asserted success in rheumatism. Chronic diarrhoea, when due to hepatic sluggishness, has been checked by this agent, and it is said to be of some value in gastric, duodenal, and biliary catarrh, with jaundice. It is commonly prepared in the form of a fluid extract, the dose of which is from 10 to 60 minims, repeated, a required, 2 or 3 times a day. The powder may be given in 5-grain doses; the solid extract in 2 or 3-grain doses.

Specific Indications and Uses.—Constipation, due to neglect or to nervous and muscular atony of the intestinal tract; lesser ailments, depending solely upon constipation, with intestinal atony.

Related Species and Pharmaceutical Preparations.Rhamnus californica, Eschscholtz (Frangula californica, Gray), California coffee tree, California buckthorn. This agent constitutes a portion of some commercial lots of cascara sagrada. (For its differentiation from other species of Rhamnus, in powder, see Amer. Jour. Pharm., 1897.) It was introduced as a remedy for rheumatism by Prof. H. T. Webster, M. D., of California, who contributed an article—"Rhamnus Californica in Rheumatism"—to the Eclectic Medical Journal, in July, 1895. Prof. Webster (Ec. Ann. of Med. and Surg., 1895, p. 30) says of it: "Rhamnus californica is commonly known as the California coffee tree. It is a shrub, which grows to the height of 20 feet in some instances, and bears a berry which is first green, then red, and finally, when ripened, black in color. This berry contains 2 seeds, resembling coffee-beans in shape, the flattened and grooved sides of the two lying in apposition, and being covered with a thin, sweetish-bitter pulp, resembling the choke cherry in taste, though the berry is as large as a marrowfat pea. It grows in the Sierras, in the coast range, and along the coast from Santa Barbara as far north as southern Oregon." In this connection, Dr. Rusby states (Amer. Jour. Pharm., 1890, p. 532) that Rhamnus californica grows sparingly in northern California, but becomes more abundant southward and eastward, through Mexico and Arizona, while Rhamnus Purshiana is abundant from northern California northward, so that the place of collection forms presumptive evidence of the botanical origin of the bark. "It has been used in domestic practice as a substitute for Rhamnus Purshiana, and it has, doubtless, been a common practice to sophisticate the latter with the bark of Rhamnus californica, the resemblance between the two barks being very great, except that the bark of Rhamnus californica is thinner. California wholesale druggists designate the bark of the Rhamnus californica as 'thin cascara bark.' Rhamnus californica (the bark) seems to me to be the most positive remedy for rheumatism and muscular pain of rheumatoid character that I have ever employed. A saturated tincture of the fresh bark, made in alcohol, may be administered in 15 or 20-drop doses, every 3 or 4 hours, in ordinary cases of acute rheumatism; 3 or 4 doses a day will answer in chronic cases. The preferable form of administration is that of a decoction of the recently dried bark. A heaping tablespoonful of the finely-broken bark is covered with a pint of cold water and steeped over a slow fire, it being allowed to simmer 15 or 20 minutes after reaching the boiling point. Of this 1 or 2 tablespoonfuls may be administered every 3 or 4 hours. If a laxative effect follows this dose, the amount to be administered must afterward be reduced until the cathartic effect is avoided. Catharsis is not necessary for its effective action. I have found it very effectual in long-standing and obstinate dysmenorrhoea (not requiring surgical interference). It may be administered in the manner already described, and should be continued 3 or 4 months, about 4 times a day. The dose of specific Rhamnus californica ranges from 10 to 30 drops. A variety of this plant, with white, tomentose leaves, is said to grow in New Mexico and Arizona" (Webster).

KASAGRA.—This is a palatable preparation of cascara sagrada (a mild laxative), prepared exclusively by Messrs. Frederick Stearns & Co., Detroit, and was introduced by this firm under the name of "Cascara Aromatic."

ELIXIR PURGANS.—This compound is prepared exclusively by Eli Lilly & Co., Indianapolis, Ind., and is extensively used as a pleasant purgative and laxative. It contains and fully represents Rhamnus Purshiana, Euonymus atropurpureus, Cassia acutifolia, (purified), Iris versicolor, and Hyoscyamus leaves combined with aromatics.

Colubrina reclinata, Brongn., Mabee bark.—South America. Contains 9.7 per cent of a bitter glucosid (W. Elborne and H. Wilson, Pharm. Jour. Trans., Vol. XV, 1885, p. 831), and is employed in the West Indies as a gastric stimulant.

Colubrina asiatica, Brongn. (Ceanothus asiatica, Linné; Rhamnus laevigatus, Sol.).—Fiji Islands and Australia. The leaves are used by natives of the Fijis to cleanse the hair and destroy vermin (Maiden)

Alphitonia excelsa, Reissek (Colubrina excelsa, Fenzl), Red ash, Leather jacket.—Australia. Used occasionally in tanning (Maiden).

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