Podophyllum. (May Apple.)
For common use, prepare a tincture from the root in the proportion of ℥viij. to Alcohol 76° Oj. Dose gtt. j. to ʒss.
I am satisfied that a trial of a tincture of Podophyllum will satisfy any one that it is preferable to Podophyllin in general practice. It makes no difference whether it is to be used as a stimulant to the digestive tract, as an alterative, for its general cathartic effect, or as an emeto-cathartic.
For its stimulant influence and to improve digestion, I frequently use it in combination with the stomachic bitters, or Nux Vomica, Quinia, and Iron; necessarily the dose is small. As an alterative, a remedy to increase waste, it may be combined with other agents that act in the same direction, with the bitter tonics and restoratives, or many times with Veratrum. A common prescription of mine is Rx Tincture of Veratrum, ʒss.; Tincture of Podophyllum, Tincture of Nux Vomica, aa ʒj. Water, ℥iv. A teaspoonful every four hours. In place of water, the vehicle may be simple syrup or glycerine, a tincture of Mentha Viridis or of Amygdalus. The case in hand will suggest the best vehicle.
I am well satisfied that in small doses, associated with the bitter tonics and restoratives and good food, it is decidedly the best remedy we have in the treatment of old syphilitic lesions. Its action may be greatly aided sometimes by the use of the vaporbath, or by sulphur and iodine baths.
For common use in malarial fevers, where the tongue is uniformly coated yellow, I would suggest its combination with Veratrum and Aconite, as in the following: Rx Tincture of Veratrum, gtts. xx.; Tincture of Aconite, gtts. x.; Tincture of Podophyllum, ʒss. to ʒj.; Water, ℥iv. A teaspoonful every hour.
For the ordinary routine of medicine, as a cathartic combine it with neutralizing cordial, as Rx Tincture of Podophyllum, ʒij. to ℥ss. Compound Syrup of Rhubarb, ℥jss. A teaspoonful every two or three hours. The addition of a small portion of Tinctures of Lobelia or Ipecac will render its action more efficient and kindly. As an emeto-cathartic give it with a ginger-tea, or other stimulant taken freely.
To obtain the direct action of Podophyllin, we prepare it for use by thorough trituration with sugar of milk or white sugar. I prefer the trituration one part of Podophyllin to one hundred of sugar.
The specific use of Podophyllin in this form is to arrest increased mucous secretion from the small intestine and give it power to perform its function. It will cure acute or chronic diarrhoea with mucous discharges, and in some cases of cholera infantum it "acts like a charm." No one who has used the trituration of Podophyllin in these cases would be willing to dispense with it, and many will find it of advantage in other cases.