Water 600 grams.

Boil for 15 minutes in a covered vessel, cool, filter and add water enough to make a liter. Dose, 30-50 grams per diem.

This preparation is also used in astringent gargles and injections. For internal use the decoction is rendered more active by adding a small quant.i.ty of cloves or cinnamon. This mixture with the addition of opium gives excellent results in the treatment of diarrhoea among the natives of India and is highly recommended by Dr. Kirkpatrick.

The most important part of the pomegranate, however, is its root, the bark of which is a very efficient taenifuge and the most astringent portion of the plant. It should be used fresh, as drying destroys its activity and gives negative results. Many failures to expel the taenia are probably due to this fact. According to Beranger-Feraud the root gives 25% to 40% of cures, whereas pumpkin seeds give but 5% to 10%.

Decoction.--(French Codex.)

Fresh bark of pomegranate root 60 grams.

Water 750 grams.

Macerate 6 hours, boil over slow fire till reduced to 500 grams. Strain. Administer fasting, in 3 doses half an hour apart. The evening before the patient should eat a light meal and take a cathartic in order that the intestinal ca.n.a.l may contain the smallest possible quant.i.ty of faecal matter. After taking the third dose of the decoction the patient should take a mild purgative such as 30 grams of castor oil to expel the taenia. This preparation has a most disagreeable taste. It is better to give the "tannate of pelletierine," a compound of tannin and one of the alkaloids that Tanret discovered in pomegranate root. A sufficient dose of tannate of pelletierine is 30-40 centigrams in wafer form, followed by a purge and with the other precautions and preparatory measures mentioned above. It causes toxic symptoms similar to those produced by curare, according to the experimental studies of Dujardin-Beaumetz and Rocheniere. Its action is upon the ends of the motor nerves. A dose of 40 centigrams may cause in man such symptoms of intoxication as vertigo, inverted vision and muscular paralysis. Pelletierine should not be administered to children, but Beranger-Feraud states that the tannate may be safely given them, as follows:

Tannate of pelletierine 0.30 grams.

Sweetened water 40.00 grams.

A coffee-spoonful of this solution contains 0.03 gram of the tannate, and this quant.i.ty may be given to a child, in a little milk. If no symptoms supervene within one-half hour give another similar dose and so on up to 3 or 4 doses or .12 gm. in all. After the last dose give the purgative as a routine. It is certainly imprudent to trust the administration of such a drug to any one incapable of recognizing the symptoms of intoxication, and as no one but a physician can judge the effects of the alkaloid he himself should remain with the patient until the efficient dose has been absorbed. This is manifestly impractical and we therefore maintain that the alkaloid is not suited for the treatment of children.

An a.n.a.lysis of the root bark made by the French chemist Tanret revealed the presence of four alkaloids: pelletierine, isopelletierine (C_8_H_15_NO), pseudo-pelletierine (C_9_H_15_NO), and methylpeletierine (C_9_H_17_NO).

Botanical Description.--A shrub 6-9 high with branches terminating in thorns; some of the branches abort and form thorns. Leaves simple, oval, oblong, without stipules, with short petioles. Flowers axillary, solitary or in pauciflorous cymes. Calyx, 4-8 sepals, persistent, fleshy, yellow or red. Corolla, 4-8 petals, imbricated. Stamens numerous, free. Style 1. Stigma thick. Fruit with leathery rind, about size of small apple, packed with seeds, each imbedded in a small amount of crisp, juicy pulp.

ONAGRACEae.

Evening Primrose Family.

_Jussiaea suffruticosa_, L. (_J. villosa_, Lam.; _J. erecta_, Blanco.)

Nom. Vulg.--_Malapoko_, Tag.

Uses.--The entire plant reduced to a pulp and mixed with milk is used in India to treat dysentery. Ainslie states that the decoction is employed as a vermifuge and purgative.

Botanical Description.--An herb with square stem, leaves alternate, lanceolate, nearly entire, glabrous. Flowers axillary, yellow, solitary. Calyx of 4-5 lobules. Corolla, 4 lanceolate petals inserted between the divisions of the calyx. Stamens 8, of these 4 alternate being shorter. Ovary very long, inferior, with 4 many-ovuled locules. Style the same length as the stamens. Stigma 4-lobuled. Seed vessels very long, with faint longitudinal ridges, crowned by the remains of the calyx, 4 pluriovulate locules.

Habitat.--In the arable fields and along the banks of rivers. Blooms in January and March.

Pa.s.sIFLORACEae.

Pa.s.sion Flower Family.

_Carica Papaya_, L.

Nom. Vulg.--_Papaya_, in many Phil. dialects; _Papaya_, _Papaw_, Eng.

Uses.--The decoction of the leaves is used locally in sores and atonic ulcers, followed by a poultice of the boiled and mashed leaves. The natives use the cold infusion of the leaves to wash clothes spotted with blood and the spots disappear rapidly by virtue of the ferment papain which digests the fibrin. The infusion is also very useful as a wash for sores and gangrenous ulcers, modifying their appearance very rapidly.

Before proceeding further it is desirable to give a description of papain, a digestive ferment which exists throughout the whole plant, fruit, trunk, leaves and petioles; it is contained in the milky juice which exudes from all these parts when cut. This juice was studied simultaneously by Wurtz in France and Peckolt in Brazil. The best method of collecting it is to make several superficial, longitudinal incisions in the green fruit without removing it from the tree; immediately an abundance of juice appears in the incisions and coagulates rapidly. The best time to do this is the early morning. The fruit does not suffer by this process but continues developing and ripens perhaps more rapidly, at the same time improving in flavor, becoming sweeter; the seeds, however, atrophy and lose their power of germination. Peckolt gives the following as the composition of the juice:

A substance a.n.a.logous to caoutchouc 4.525 Awa 2.424 Soft resin 0.110 Brown resin 2.776 Alb.u.minoids 0.006 Papayotin (Papain of Wurtz) 1.059 Extractive matter 5.303 Malic acid 0.443 Peptic material and salts 7.100 Water 74.971

The milky juice is neutral and coagulates rapidly, separating in two parts: a kind of insoluble pulp and a limpid colorless serum. If combined with fibrin, raw meat, white of egg or gluten it gradually softens them and completely dissolves them in 3 or 4 hours _in vitro_ at 40 C. Combined with milk it coagulates it and soon precipitates the casein which is also dissolved a little later. It digests lumbricoids and tape-worms and the false membrane of croup, in a few hours. According to Wurtz and Bouchut papain is prepared as follows:

The fluid juice or the aqueous solution of the milky exudate is precipitated by the addition of ten times the volume of alcohol. The precipitate, after treating again with concentrated alcohol, is dissolved in water and the addition of sub-acetate of lead eliminates the alb.u.minoids and peptones but does not precipitate the papain. The liquid is filtered and the lead salts separated by means of a current of hydrogen sulphide. It is filtered again and alcohol added gradually, which process first precipitates whatever sulphate of lead may have pa.s.sed through the filter, and then the papain.

Papain is an amorphous substance, perfectly white, soluble in water, insipid, odorless. An aqueous solution, if shaken violently, foams like a solution of soap. Boiling makes it turbid and when concentrated it has a slightly astringent taste. It is precipitated by hydrochloric, nitric, picric and the metaphosphoric acids. Trommer's test gives it a beautiful blue violet color which, on boiling, changes to a red violet.

It is an extremely active digestive ferment, comparable with pepsin, but superior to the latter because it does not require an acid medium, as its digestive action takes place even in the presence of an alkaline medium and of antiseptic substances such as boric acid, phenol, etc. It is given in doses of 10-40 centigrams in different vehicles such as water, wine, etc. It should be given after meals carefully and properly diluted, in order that its action may not be exerted upon the gastric mucous membrane itself. Its use is contraindicated in gastric ulcer.

A watery solution prepared by macerating the green fruit has been used effectively to remove blemishes from the face, leaving the skin clean and smooth. The natives use little pieces of the green fruit to remove freckles (which they call _pecas_). The ripe fruit is edible and its taste quite agreeable; in some of the Malay Islands it is given for dysentery, but it must be remembered that the ripe fruit does not contain papain.

The pure exudate is given to children as an anthelmintic in doses of 2-6 grams with a little mola.s.ses, but it is not so harmless that it may be used with impunity in this form, Moncorvo and others having reported cases of peritonitis with symptoms suggestive of cholera following its use. It is drastic and digestive in addition to its anthelmintic action, but according to Rabuteau, boiling destroys the first property without affecting the others. Dr. Lemarchand of the island of Mauritius gives the following anthelmintic prescription:

Juice of papaya and mola.s.ses aa 1 tablespoon.

Add gradually while shaking the mixture.

Boiling water 4 tablespoons.

Cool and administer in one dose followed immediately by 30 grams of castor oil. For a child, one-half dose.

This treatment frequently causes colic, for the relief of which the author advises an injection of sweetened water. Sir O'Shaughnessy's prescription is preferable:

20-60 drops of the exudate in a little sweetened water.

This dose cannot cause any untoward symptoms and is efficient in expelling both lumbricoids and taeniae.