The root of Cephaelis ipecacuanha.-Brazil.
Related entry: Ipecac under diaphoretics
Preparations.—Powder, Tincture, Syrup, Etuetinu, or Emetia.
Dose.—The dose of the powder will be from grs. x. to grs. xxx , every ten or fifteen minutes with warm water, or some warm stimulant infusion; of the tincture gtt. x. to ʒss., every ten minutes with warm water or a warm infusion. Emetia is rarely used by hypodermic injection, the dose being one to two grains.
Therapeutic Action.—Ipecacuanha is emetic, diaphoretic, expectorant, laxative and alterative. In full doses it is one of the mildest and most valuable emetics known. If it does not produce emesis, it generally soon proves cathartic. If administered in smaller doses, it acts as a stimulant, diaphoretic, expectorant, or laxative; and in still smaller doses, as a tonic and alterative. Its first effect upon the system, when administered, is that of a stimulant, or irritant to the mucous membrane of the stomach, and not until its active properties have been absorbed, does it cause nausea, depression, and vomiting. Hence it belongs to the class of specific emetics,—those which produce emesis when introduced into the circulation from any part of the system.
As an emetic the ipecacuanha does not depress the system like many other of the vegetable emetics. It may, therefore, be resorted to in cases of debility, when other agents would he inadmissible. As a mild, effectual agent it may be prescribed whenever there is a foul state of the stomach, arising from a redundancy of mucus, or of the biliary secretion, or retained indigestible aliment. Its mildness and efficiency recommend it, when the object is simply to evacuate the stomach, or when a gentle influence of this kind only is desirable.
Its gentle action also renders it a very popular and highly valuable emetic, in numerous diseases of children.
It is used in minute doses as an alterative, either alone or combined with other agents, as sulphur, cream of tartar, guiacum, sarsaparilla, podophyllin, sanguinaria, taraxacum, etc. In hepatic torpor, and where there was obvious derangement of the chylopoietic system, we have often combined it with the extract of taraxacum, podophyllum, and sanguinaria, forming the mass into pills, which have proved highly beneficial.
In small doses it often proves valuable as a stimulant, tonic, and alterative, in dyspepsia, and other diseases, combining it with some of the bitter tonics, the action of which it facilitates.
It is sometimes combined with cathartics; two or three grains of it greatly facilitate the action of these agents, and even render small doses more efficient than large ones, when given uncombined.
As an expectorant and diaphoretic it is often combined with the more stimulating agents, as the squill, senega, etc.
Specific Indications.—Irritation of bronchial mucous membrane and air-cells; irritation of stomach; irritation of small and large intestines.
Specific Uses.—In acute bronchitis and pneumonia; in nausea, vomiting, and irritative dyspepsia; in cholera infantum, diarrhoea, dysentery, menorrhagia, and hemoptysis.
In bronchitis, and especially in pneumonia, Ipecac in small doses takes a first place. As the pulse is frequent and the temperature increased, it is usually combined with Aconite.
In irritation of the stomach, especially if the pulse is frequent, and the temperature is increased, Ipecac is the remedy.
In cholera infantum, Ipecac is suggested as a principal remedy. With frequent pulse and increased temperature of the abdomen, it is given with Aconite. With pallid or yellowish face, abdominal pain, pallid tongue, nausea and vomiting, it is associated with Nux.
In the ordinary diarrhoea of irritation Ipecac is a very certain remedy. Give it with Aconite or Nux, as may be indicated.
In the common form of dysentery—colitis, or simple inflammation of the large intestine—Ipecac is as near a specific as we can imagine. In zymotic dysentery it may form a part of the treatment, but anti-zymotics will take precedence.
Dose.—For these uses the dose will be small—Tinct. Ipecac gtt. v. to gtt. xv., water ℥iv.; a teaspoonful every hour.