N. H.—South America, New Granada.
Properties: In minute doses tonic and stimulant; in large doses expectorant, diaphoretic and emetic.
Physiological action: Powdered ipecac applied to the skin will produce irritation, redness and pustulation. The powder when inhaled is an irritant to the mucous membrane and will cause in many, sneezing, asthmatic breathing; epistaxis, spitting of blood, and in some cases swelling of eyes, face and throat. This may often be counteracted with quebracho or uva ursi. In small doses it is a stimulant. In large doses a depressant. In small doses of ⅛ to ¼ of a grain it stimulates salivary and gastric secretion and has a general tonic effect on the stomach. In doses of ½ to 1 grain it is a good expectorant, while in 2 grain doses it is diaphoretic. In larger doses of x to xx grains its first effect is stimulating, after which it will produce nausea and vomiting. It is milder and slower than other emetics but is less depressing. Ipecac has a marked effect on the pneumogastric nerve. In many cases repeated emetic doses will produce a toleration of the stomach, the emetic affect being lost, and it acts as a cathartic, the feces having a bilious color. Specific ipecacuanha is preferable to the powder in most cases.
Indications: Persistent irritation of the mucous membrane with lack of secretion, especially in acute inflammatory condition. Irritation of digestive tract indicated by contracted elongated pointed tongue with red edges. In all these cases it should be given in small doses. As an emetic in large doses it is indicated where there is an accumulation in the stomach, with broad, flabby, pale and heavily coated tongue, showing inactivity. Nausea and vomiting with pale relaxed membrane. Taken in cold liquid in minute doses it is useful as a styptic, arrests nausea and vomiting and diarrhea. It is diaphoretic, expectorant and emetic. As an emetic it is slower than lobelia but is less depressing and often acts both as an emetic and laxative. Taking it in warm water makes its action more prompt in such cases. We think of it in acute bronchitis, bronchitis in children. In infantile pneumonia it is an excellent remedy. Cough with deficient secretion. In hemorrhage it is a useful remedy in good sized doses. In dysentery and diarrhea it is one of our best agents, especially if combined with aconite. In croup, associated with sanguinaria, it is of great value. Its long continued use may cause a diarrhea in some people and therefore discretion should be used. In minute doses it is one of our best remedies to excite the stomach to motor activity. Here it is given in small doses after meals. Syrup of ipecac is made of tincture ipecac 1 ounce; simple syrup 7 ounces. Used as an expectorant.