CALUMBA (Jateorhiza palmata)^JAPA2
   The root of Jateorhiza palmata (Lamarck), Miers (Nat. Ord. Menispermaceae). A climbing perennial, the Kalumb of the Southeast coast of Africa. Dose, 1 to 30 grains. Common Names: Columbo, Colombo, Columba. Principal Constituents.—Calumbin(C42H44O14), a bitter principle, berberine (C20H17NO4) with columbic acid, and columbine, a possible white alkaloid, may be present. No tannin is present. Preparations.—1. Infusum Calumbae, Infusion of Calumba. Dose, 1 to 2 fluidounces. 2. Specific Medicine Calumba. Dose, 5 to 30 minims. Specific Indications.—Enfeebled stomach with indigestion, or feeble digestion; anorexia and debility. Action.—This is a type of the pure, simple bitters which contain practically no oil or tannin, are not astringent and have no general effect, but act reflexly upon the stomachic and salivary functions by first irritating the mucous membrane and taste buds of the tongue. This action is quite transitory, so that in administering bitters they should be given immediately before meals. Their effect upon the stomach is to increase local circulatory dilation, a freer flow of gastric juice, increase of mucus, and increased muscular action. On account of the action upon the flow of mucus they should not be administered for too long a period lest gastric irritability and consequent impaired digestion result. Therapy.—The least irritating and one of the best of the simple bitters and of especial value in atony of the stomach with poor appetite and feeble digestion. It is especially valuable in convalescence from acute fevers and other disorders in which there is lack of desire for food and poor digestion, with pain or without pain, immediately upon eating. After the active stage of cholera morbus, cholera infantum, acute diarrhoea, and dysentery it may be given to promote the appetite and digestion. When desired calumba may be combined with magnesia, bicarbonate of soda, senna, ginger, and aromatics, to meet special indications, particularly when flatulence and constipation are present. Calumba and the allied bitters should not be given in acute or subacute inflammatory conditions of the stomach, nor during acute fevers, nor when digestion is merely impaired, but the appetite remains good. It is largely ineffectual also when organic disease of the stomach prevents the normal outflow of gastric juice. When given, the small doses are preferable to large ones; and on account of the absence of tannin, iron salts may be given with calumba, if so desired. In some respects calumba resembles hydrastis in its local action, and indirectly, by favoring better digestion, the quality of the blood is improved, hence its value in anemia during convalescence.¹

CASSIA MARILANDICA
   The leaves of Cassia marilandica, Linné (Nat. Ord. Leguminoseae). An American perennial herb of the eastern half of the United States. Common Names: American Senna, Wild Senna. Principal Constituent.—A body resembling cathartin, and thought to contain chrysophan. Preparation.—Infusum Cassiae Marilandica Compositum. Compound Infusion of American Senna (Leaves, 1 ounce; Coriander Seeds, 1 drachm; Boiling Water, 16 ounces. Dose, 4 to 5 fluidounces. Action and Therapy.—An excellent cathartic that may be used as a substitute for senna.¹

FICUS
   The fleshy receptacle of Ficus Carica, Linné bearing fruit on its inner surface. (Nat. Ord. Moraceae.) Persia and Asia Minor; cultivated in all mild latitudes. Common Name: Fig. Action and Therapy.—External. Emollient. A roasted, boiled, or raw fig is exceedingly efficient to hasten suppuration in gum boil, boils in the nose or ears and elsewhere, and in buboes and carbuncles. The great surgeon, Billroth, employed a poultice of dried figs and milk to overcome the stench of cancerous and fetid ulcers. Internal. Nutritive, demulcent, and aperient. Figs are frequently resorted to by individuals inclined to constipation. An elegant aperient confection is employed by the laity under the homely name of “fruitcake.” It is prepared by pounding together in a mortar equal quantities of figs, dates, raisins, prunes, and senna leaves. This is wrapped in tinfoil, and sliced off and eaten according to the requirements of the individual.¹

GLYCYRRHIZA
   The dried rhizome and roots of Glycyrrhiza glabra typica, Regel et Herder (Spanish Licorice), or of Glycyrrhiza glabra glandulifera, Regel et Herder (Russian Licorice), (Nat. Ord. Leguminosae). Southern Europe and western Asia; cultivated. Dose, 5 to 60 grains. Common Names: Licorice, Licorice Root, (1) Spanish Licorice Root, (2) Russian Licorice Root. Principal Constituents.—The sweet glucoside glycyrrhizin (C24H36O9), asparagin, glycyramarin and an acid resin. Preparations.—1. Specific Medicine Glycyrrhiza. Dose, 5 to 60 drops. 2. Fluidextractum Glycyrrhizae, Fluidextract of Glycyrrhiza. Dose, 30 drops. Derivative: Glycyrrhizinum Ammoniatum, Ammoniated Glycyrrhizin. Very sweet, odorless, dark-brown or red-brown scales; soluble in alcohol or water. It is derived from glycyrrhiza and combined with ammonia. Dose, 1 to 8 grains. Action and Therapy.—Glycyrrhiza root is demulcent, laxative, and expectorant. It acts upon mucous surfaces, lessening irritation and relieving coughs, catarrhs, and irritation of the urinary tract. The powdered extract is sometimes used to give solidity to pills, and the powdered root as a dusting powder for the same. The fluidextract is an agreeable flavoring agent for other medicines and soothing to irritated bronchial surfaces. The bitterness of cascara, quinine, aloes, quassia, the acridity of senega, guaiac, and the taste of ammonium chloride and sodium salicylate are more or less masked by the fluidextract. Licorice root is an ingredient of Compound Licorice Powder. (See Senna).¹

JALAPA (Ipomea jalapa)
   The dried tuberous root of Ipomoea jalapa, Nuttall; (Ipomoea purga, Hayne; Exogonium jalapa, Baillon; Exogonium purga, Bentham). Nat. Ord.Convolvulaceae. A vine of Eastern Mexico. Dose, 10 to 30 grains. Common Name: jalap. Principal Constituents.—A resin (Resina Jalapae) composed chiefly of Jalapurgin (C62H100O32) (convolvulin or jalapin) and a soft acrid resin. Preparations.—1. Resina Jalapae, Resin of jalap. Yellowish-brown or brown masses or fragments, or a yellowish-gray or yellowish-brown powder, permanent, of a faint but peculiar odor, and somewhat acrid to the taste. Soluble in alcohol. Dose, 2 grains. 2. Pulvis Jalapae Compositus (U. S. P.), Compound Powder of jalap. (jalap, 35; Potassium Bitartrate, 65.) Dose, 20 to 60 grains. (Locke advises Ginger, 3 drachms, in 8 ounces of this preparation to prevent griping.) 3. Pulvis Jalapae Compositus (Eclectic), Compound Powder of jalap (Eclectic), or Antibilious Physic. (Senna, 2 ounces; Jalap, 1 ounce; Cloves or Ginger, 1 drachm.) Dose, 60 grains (in hot water allowed to cool and then sweetened). 4. Specific Medicine Jalap. Dose, 5 to 20 drops. Specific Indications.—Intestinal torpor and constipation from deficient secretion of the intestinal glands; pain and griping in the lower bowel. Action and Therapy.—Jalap is an irritant cathartic operating energetically and producing large liquid stools. It gripes considerably and sometimes causes nausea and vomiting. Large doses produce violent hypercatharsis, sometimes resulting in death. It is a safe and thorough cathartic when no inflammation of the gastro-intestinal tract exists, and may be used where a derivative action, with full stools, is indicated. In small doses (5 grains daily) it may be employed to relieve constipation due to inactivity of the intestinal glands or where hard fecal masses are impacted in the rectum. Movements are facilitated by the secretion induced. It is a useful revulsive in cerebral congestion, and may be used in hemorrhoidal conditions with constipation when a stimulating cathartic cannot be employed. The chief use of jalap is for the relief of dropsy from any cause. It is commonly used with cream of tartar, which increases both the cathartic and diuretic effects. It should not be given for any great length of time, for the depletion finally has a depressing effect upon the heart. Though contraindicated in inflammation of the intestinal tube, it may be used when there is inflammation of the biliary apparatus, and when a cathartic is needed at the onset of fevers. The Antibilious Physic and that modification of the compound powder as advised by Locke are desirable forms in which to use jalap. Jalap alone purges in about 3 to 4 hours.¹

SARSAPARILLA^SMAR
   The dried root of (1) Smilax medica, Chamisso and Schlechtendal; or (2) Smilax officinalis, Kunth, or an undetermined species; or (3) Smilax ornata, Hooker filius (Nat. Ord. Liliaceae). Tropical America, Mexico to Brazil. Dose, 30 grains. Common Names: Sarsaparilla; (1) Mexican Sarsaparilla; (2) Honduras Sarsaparilla; (3) Jamaica Sarsaparilla. Principal Constituents.—The acrid glucoside parillin (smilacin, salseparin, or parillic acid) closely resembling saponin; resin and a volatile oil; and calcium oxalate, etc. Preparations.—1. Specific Medicine Sarsaparilla. Dose, 1 to 30 drops. 2. Fluidextractum Sarsaparillae Compositum, Compound Fluidextract of Sarsaparilla (contains Sarsaparilla, Licorice, Sassafras, Mezereum). Dose, 10 to 60 minims. 3. Syrupus Sarsaparillae Compositus, Compound Syrup of Sarsaparilla (contains Fluidextracts of Sarsaparilla, Licorice, Senna, Oil of Sassafras, Oil of Anise, and Methyl Salicylate, Alcohol, Sugar, and Water). Dose, 2 to 6 fluidrachms. Action and Therapy.—Sarsaparilla once held a high reputation as an alterative; it is now considered practically valueless. Almost the only use made of it at present is as a vehicle for iodides and other alteratives. For this purpose the compound syrup is largely preferred. Sarsaparilla is not wholly inert and its long-continued use may cause ulceration of the mucosa of the intestines. Some believe it also to possess an active cardiosedative principle, probably sarsaponin.¹

SENNA^SENNA
   The dried leaflets of (1) Cassia acutifolia, Delile, or of (2) Cassia angustifolia, Vahl (Nat. Ord. Leguminosae). (1) Eastern and central Africa; (2) cultivated from eastern Africa to India. Dose, 60 to 120 grains. Common Names: Senna, (1) Alexandria Senna, (2) India or Tinnivelly Senna. Principal Constituents.—An amorphous, water-soluble, sulphurated glucoside—cathartinic acid (which may be split into cathartogenic acid and glucose), emodin, sennacrol and sennapicrin (water-insoluble glucosides), and chrysophanic acid. Preparations.—1. Specific Medicine Senna. Dose, 5 to 60 drops. 2. Infusum Senna Compositum, Compound Infusion of Senna (Black Draught). (Senna, Manna, Magnesium Sulphate, Fennel, Boiling Water.) Dose, 2 to 8 fluidounces. 3. Pulvis Glycyrrhiza Compositus, Compound Powder of Glycyrrhiza (Compound Licorice Powder), (Senna, Glycyrrhiza, Oil of Fennel, Washed Sulphur, Sugar). Dose, 1 to 2 drachms. 4. Pulvis Jalapa Compositus, Compound Powder of jalap (Antibilious Physic). Contains Senna. See Jalapa. Specific Indications.—Flatulence and colic; a laxative for noninflammatory conditions of the intestinal tract. Action and Therapy.—Senna is a manageable and useful cathartic producing copious yellowish-brown evacuations, and causing considerable griping when used alone. While it influences the whole intestinal tract, exciting peristalsis as it passes along, the greater action is exerted upon the colon. This renders it a certain purgative, for by this sequence the whole canal is the more readily emptied. It does not produce after-constipation, as does rhubarb and some other laxatives; and it may purge a nursing infant when administered to the mother. Senna is neither sedative nor refrigerant, but if anything somewhat stimulant, and is, therefore, not to be given in irritated or acutely inflamed conditions of the alimentary tube nor when there is great debility, or hemorrhoids, or prolapse of the rectum. Notwithstanding, it is effectual and safe to cleanse the bowels at the beginning of fevers, when such an effect is desired. It may be used as a laxative or more complete cathartic in children and adults when a severe action is not indicated. In most individuals it occasions nausea, tormina and flatulence when given alone, as in senna tea, but these effects may be mitigated by infusing it with coffee, or by the addition of cloves, ginger, peppermint, cinnamon, or other aromatic corroborants. Cream of tartar added to it increases its action, producing a hydragogue and refrigerant effect, while bitters in general seem to increase its action. Senna is one of the anthracene group of cathartics, and its action is largely, though not wholly, due to the presence of cathartinic acid. The latter taken up by the blood, or injected, is emptied into the intestinal canal, thereby causing or prolonging catharsis. Compound Powder of Jalap. A most thorough action may be obtained from the Antibilious Physic, especially in auto-intoxication, and intestinal toxemia, giving rise to a violent, burning, diffuse rash, such as sometimes follows prolonged constipation, or the ingestion of tainted foods—particularly sea foods and fruit. This preparation is less irritant than senna alone, and unless there is very marked gastro- intestinal inflammation, it is seldom contraindicated. The physicing dose is one drachm, in hot water, cooled and sweetened; or milk, lemonade, or coffee may be used as a vehicle. It may also be given in large-sized gelatin capsules. Compound Licorice Powder. A pleasant and efficient laxative in doses of 30 to 120 grains (average 60), given in plenty of water, at bedtime, for the general cleansing of the bowels of undigested material, relieving headache arising therefrom; and an admirable laxative for the pregnant and parturient woman, and for children. It may be given in water, or the readyprepared lozenges may be used, the patient partaking also of plenty of water.¹

SPIGELIA
   The dried rhizome and roots of Spigelia marilandica, Linné (Nat. Ord. Loganiaceae). Southern United States; less plentiful in northern parts of eastern half of the Northern States. Dose, 1 to 2 drachms for adults; less for children. Common Names: Pinkroot, Maryland Pink, Carolina Pink, Worm-grass. Principal Constituents.—A volatile alkaloid, spigeline (resembling coniine and nicotine), volatile oil, resin, and a bitter body. Preparations.—1. Specific Medicine Spigelia. Dose, 5 to 60 drops (full dose as anthelmintic). 2. Fluidextractum Spigelia et Senna, Fluidextract of Spigelia and Senna. Dose, 30 to 60 drops. Specific Indication.—Lumbricoids. Action and Toxicology.—In large doses spigelia is toxic, causing increased cardiac action, cerebral disturbances, as dizziness, dimness of vision, dilated pupils, facial and palpebral spasms, general convulsions and stupor. Purgation often results from such quantities. Catharsis minimizes the danger of unpleasant symptoms, therefore it is usually administered with a cathartic, as senna. Therapy.—Pink root is an active and very certain vermifuge, removing the round or lumbricoid intestinal worm. The powdered root (5 to 20 grains for a young child; 1 to 2 drachms for an adult) or the fluidextract, or specific medicine in equivalent dosage may be given twice a day, together with or followed by an active purgative. Senna is usually preferred. Ellingwood advises Rx Fluidextract of Spigelia, 2 fluidrachms; Santonin (powdered), 15 grains; Simple Elixir, enough to make 2 fluidounces. Mix. Sig.: One teaspoonful every night and morning, followed on the third day by a non-irritating laxative. Many who are old enough will recall the days of domestic medication when pink and senna (popularly pronounced seeny) tea was a regular feature of child raising. Interest has been attracted to spigelia, chiefly of homeopathic origin, as a remedy in heart affections, particularly endocarditis of rheumatic origin and to guard against relapses of cardiac rheumatism. Cardiac neuralgia with palpitation and pain extending along the arm is also said to be relieved by it. For these purposes the fractional dose is to be preferred. Rx Specific Medicine Spigelia, 10-15 drops; Water, 4 fluidounces. Mix. Sig.: One teaspoonful every two hours. Large doses are said to debilitate the heart.¹