BALSAMUM PERUVIANUM
   A balsam obtained from Toluifera Pereirae (Royle) Baillon. San Salvador in Central America; called Balsam of Peru because first exported to Europe from Peru. Common Names: Balsam of Peru, Peru Balsam. Description.—A dark brown, heavy fluid of syrupy consistence, without stickiness and non-hardening in the air, and having a vanilla-like odor, and an acrid, bitter persistent taste. It is soluble in alcohol and chloroform. Principal Constituents.— Cinnamein or benzylic cinnamate (C9 H7 (C7 H7) 02) constitutes 60 per cent of Peru balsam. Other constituents are vanillin, styracin, a fragrant oil and a large proportion of resin. Action.—Skin eruptions have been produced by applying the balsam to the skin, as hives, eczema, and erythema; sometimes the latter results from its internal use. These effects are thought to be due largely to impurities in the factitious drug, which is oftener sold than the genuine balsam. A good and true product allays dermal irritation and that of the mucosa, and has decided antiseptic and parasitic properties. Large doses cause gastro-intestinal irritation, with vomiting and diarrhea. Internally it causes increased circulation, some cutaneous warmth, and augments the flow of urine and the bronchial secretions. It is excreted by the respiratory mucosa, skin, and kidneys, upon which it probably exerts an antiseptic effect. Therapy.—External. Balsam of Peru is a good parasiticide and has given the best of satisfaction in scabies and for the destruction of lice. For the former it may be combined with the sulphurated ointments, or may be used alone, with an oleaginous and petrolatum base (balsam, 25 parts; olive oil, 50 parts; petrolatum, 100 parts). We prefer the former preparations. The latter combination is useful in pediculosis, both to kill the nits and the lice. Balsam of Peru, either full strength or in desired dilution with oils or petrolatum, may be used to cure ringworm of the scalp and other forms of tinea, in chronic eczema, and is splendidly effective in senile and other forms of pruritus, especially pruritus vulvae, and in chilblains. As a stimulant to ulcers of low vitality and pus-oozing granulations following operations, and similar conditions in burns, abscesses, and wounds, the old-time use of the balsam has been revived in surgery, applying it in 5 to 15 per cent solutions in castor oil, and covering well with several layers of gauze to allow of free drainage. This method is one of the best forms of treatment for old tibial ulcers, due to varicosis, but the patient must be compelled to rest the leg in a horizontal position for some weeks in order to insure results. The same solution may be poured into small granulating sinuses, produced by drainage tubes, that refuse to heal. Beef marrow, 1 ounce; quinine, 10 grains; and balsam of Peru, 1 drachm, has been advised in alopecia. Internal. Balsam of Peru is a stimulating expectorant and is of some value to restrain secretion in the bronchorrhoea of the aged. It has a similar restraining effect upon catarrhal conditions of the gastrointestinal and renal tracts and is sometimes of advantage in stubbornly resisting gonorrhoea. Peru balsam should not be used in inflammatory or febrile conditions; and its use should be discontinued if it produces gastro-intestinal irritation.¹