- The Digestion-Ferments include the three animal products named Pepsin, Pancreatin and Ingluvin, also Papain, from the vegetable kingdom.
- Pepsin,—is an organic ferment which constitutes the digestive principle of the gastric juice of animals, and is usually obtained from the mucous membrane of the pig's stomach.
- Pancreatin,—is a mixture of the enzymes naturally existing in the pancreas of warm-blooded animals, obtained from the fresh pancreas of the hog. It contains four ferments, viz.—Trypsin, Pancreatic Diastase, an Emulsifying and a Milk-curdling ferment.
- *Ingluvin is obtained from the gizzard of the domestic fowl, and owes its digestive activity to a peculiar bitter principle.
*Papain, Papaw, or Papayotin, is a ferment obtained from the milky juice of Carica Papaya, a South American fruit-tree. It is too powerful a digestor to be used internally undiluted, as it might digest the gastric mucous membrane itself.
- Preparations. Only two are official,—
- Pepsinum Saccharatum, Saccharated Pepsin,—is Pepsin from the stomach of the hog, triturated with 9 of Sugar of Milk. Dose, gr. v—xxx, after meals.
- *Liquor Pepsini, Solution of Pepsin, Liquid Pepsin,—has of the preceding 40 parts, with HCl12, Glycerin 400, in Water to 1000. Dose, ʒj-ʒij.
- Pancreatinum, Pancreatin,—is a grayish-yellow, amorphous powder, of faint odor and meat-like taste. Dose, gr. ij-v. It is marketed in various forms, Pancreatic Emulsion, Liquor Pancreaticus, etc., and is also put up with three times its weight of Sodium Bicarbonate, as Peptonic Milk Powder or "Peptonizing Tubes,"—for the preparation of Peptonized Milk.
*Ingluvin,—from the gizzard of the fowl. Dose, gr. x-xxx.
- Every manufacturer of digestion ferments has his own preparation of Pepsin and Pancreatin, and his peculiar name therefor. These various products vary considerably in their properties. A few of the most prominent are—
- *Lactopeptine,—a powder, said to contain Pepsin, Diastase, Pancreatin, Lactic and Hydrochloric Acids. Dose, gr. v-xv.
- *Jensen's Crystal Pepsin, in yellowish, translucent scales, soluble in water, and claimed to be pure pepsin without admixture. Dose, gr. j-iij.
- *Pepsine in Scales (Fairchild), is a similar preparation, gr. j of which is claimed to digest 1000 grains of albumen in 4 hours. Dose, gr. j-iij.
- *Essence of Pepsine,—a solution similar to the Official Liquor. Dose, ʒj.
- *Liquid Pancreapepsine,—is said to contain Pepsin, Pancreatin, Lactic, Hydrochloric and Phosphoric Acids. Dose, ℥ss-j, after meals.
- *Diastasic Essence of Pancreas,—for starchy foods. Dose, ʒj-ij.
- *Trypsin, the fibrin-digesting ferment of the pancreatic juice. Is used in aqueous solution, ʒss to the ℥, with gr. x of Sodium Bicarb., locally.
Scheffer's Process is the standard process for the preparation of Pepsin. The mucous membrane of a pig's stomach is scraped off and digested in a solution of HCl, and the Pepsin is then precipitated by adding a solution of NaCl. Ten grains of Scheffer's Saccharated Pepsin, with gtt. x of dilute HCl, and ℥j of water, will dissolve 200 grains of albumen in from five to six hours, at 100° Fahr.
Incompatibles. Alkalies and many mineral salts precipitate pepsin. Alcohol destroys its activity. Alkalies promote the action of pancreatin.
Physiological Action. Pepsin and Ingluvin digest the nitrogenous principles of the food (albumen, casein, fibrin, etc.) converting them into peptones for assimilation; in which they are materially aided by Lactic and HCl Acids. Official Pepsin should be capable of digesting not less than 3000 times its own weight of freshly coagulated and disintegrated egg albumen. Pancreatin digests the same principles, and in addition, with the aid of an alkali, it emulsifies fats and oils. Pepsin is an essential element of the gastric juice, and will digest pancreatin, which probably therefore never passes into the duodenum in its own character. Trypsin, unlike Pepsin, will dissolve mucin, and like Pepsin it is inert toward nuclein, horn and amyloid matter.
Therapeutics. Pepsin is indicated in atonic dyspepsia, the apepsia of infants, gastralgia, anaemia, chlorosis, gastric ulcer and cancer, diarrhoea of infants, and the vomiting of pregnancy. It is added to nutritive enemata, the rectum not being a digestive organ; and is injected into the substance of morbid growths which are homologous to the tissues, for their destruction, especially fatty tumors.
Ingluvin is particularly useful against vomiting, and has been found very efficient in the vomiting of pregnancy. Pancreatin is used to assist the digestion of oils and fats, and should be administered 2 or 3 hours after meals; whilst Pepsin is best given near meal time. The various Pancreatic preparations are used to partially digest (peptonize) milk, gruel, soups and other foods, before administration, in cases where there is great digestive debility. These peptonized foods may be administered by rectal injection (enemata), as well as by the mouth, and are invaluable in wasting diseases, in intestinal dyspepsia, and in convalescence from acute affections. A teaspoonful of Liquor Pancreaticus, taken directly after a dose of Cod liver Oil, will prevent the disagreeable eructations which so frequently follow, and will assist in the digestion of the oil.
Trypsin is used with real benefit as a solvent of the diphtheritic membrane, but requires to be thoroughly and frequently applied.
Papain is a powerful digestor of fibrin, acting in solutions of any reaction, and at higher temperatures than Pepsin will. It is a solvent of false membranes and of intestinal worms. It has been injected into tumors for their destruction, and successfully, but with much pain and considerable febrile reaction. It is used internally under the name Papoid, in doses of gr. j-iij.
A Compend of Materia Medica, Therapeutics, and Prescription Writing, 1902, by Sam'l O. L. Potter, M.D., M.R.C.P.L.