Preparations of this agent may be used. Prepare a tincture from the fresh bark in the proportion of 3viij. to Alcohol 50degree Oj. Dose, gtts. vj to gtts. xxx. Prepare a tincture from the berries, in the proportion of 3viij. to Alcohol 76degree Oj. Dose, from the fraction of a drop to two to five drops, largely diluted with water.
Buckthorn berries have been employed as a cathartic, but their activity, attended with nausea, dryness of the throat, thirst and tormina, made their use limited. The tincture of the berries in small doses may be tested for its influence on the digestive apparatus, in diseases of the nose, throat, and respiratory organs, and as a stimulant to the vegetative processes.
It is claimed that a preparation of the bark gives one of the most efficient alteratives of the Materia Medica. Dr. William Goltry claimed that a tea made of the bark or berries would cure cancer and scrofulous diseases generally. Dr. William S. Knight writes, “I have been using the Rhamnus Catharticus in all forms of scrofulous disease for the last two years (1866) with good effect. I make an infusion from the bark and let the patient drink as much as he well can during the day, so as not to act too much upon the bowels.”
The bark of Rhamnus catharticus, r. frangula, r. carolinianus, r. purshiana ‑ U.S. Preparation: A tincture of the recent bark. Dose: The dose of Rhamnus will vary from gtt. x. to 3j., according to the action desired. Therapeutic Action: All the species of Rhamnus are cathartic, differing only in their activity. In the olden time, only the berries of the Rhamnus Catharticus were employed; but from their activity and the danger of gastro‑intestinal irritation, they were but little used. Still, I am satisfied that in proper dilution and in small dose, the tincture of the seed would prove quite as good as the so much advertised Cascara Sagrada. The bark is much milder, and may be employed for the ordinary purposes of a cathartic.
The Rhamnus Purshiana, the species obtained on our western coast, has recently been quite extensively employed, and is a fairly good remedy if used with care. It is extremely nasty, and few persons will care to take it in preference to more pleasant drugs. Still it has this virtue, that there is less danger of constipation following its action, and in some cases it may break up habitual constipation. The Rhamnus Carolinensis, our southern species, is now being used in place of the Purshiana, and it is said with equally good results.
Constipation due to nervous and muscular atony of the lower bowel, with diminished sensibility, constipation due to neglect. Ten to thirty drops three times a day.
1898: Felter and Lloyd – RHAMNUS PURSHIANA (U.S.P.) – CASCARA SAGRADA
Action, Medical Uses, and Dosage - Cascara sagrade, when introduced as a medicine, was highly recommended as a certain remedy in cases of habitual constipation, and in some forms of indigestion. Further trial has substantially sustained these assertions, and it is, undoubtedly, a valuable addition to our list of therapeutical agents. It does not, however, succeed in all cases, but acts best where a tonic to the intestines is required. As it tones the whole intestinal tract, it is valuable in doses of 10 drops, after meals, for that dy…..ptic condition which depends most largely upon constipation, and is due to intestinal weakness. Administered in large doses, it has served us nicely in sick headache, due to like causes. Loss of tone in the rectum, with constipation, giving rise to hemorrhoids, is benefited by it. In chronic constipation it may be necessary to begin with the larger doses, and gradually reduce the quantity to a few drops, 3 times a day, though, as a rule, it is better to give repeated small doses, gradually increased, until the desired action is obtained, and then to gradually withdraw the drug. It acts kindly without irritating or griping, and produces stools of a semifluid consistence. Occasionally, but rarely, have reports of harsh action been made, such as cramps, colic, vomiting, and inordinate catharsis, wiile a soreness of the bowels, persistent in character, has been attributed to it. These effects, however, are not common. The remedy, in 10 to 15 drop doses, has been used with asserted success in rheumatism. Chronic diarrhoea, when due to hepatic sluggishness, has been checked by this agent, and it is said to be of some value in gastric, duodenal, and biliary catarrh, with jaundice. It is commonly prepared in the form of a fluid extract, the dose of which is from 10 to 60 minims, repeated, as required, 2 or 3 times a day. The powder may be given in 5-grain doses; the solid extract in 2 or 3 grain doses.
Specific Indications and Uses - Constipation, due to neglect or to nervous and muscular atony of the intestinal tract; lesser ailments, depending solely upon constipation, with intestinal atony.
1898; Webster; (Supplement to Pharmacological Excerpts) – Rhamnus Californica
California Coffee-tree; Bearberry. – A shrub growing from ten to fifteen feet in height, indigenous to California and Eastern Oregon . The bark of the trunk and branches and the leaves possess medicinal properties. It is one of the sources of cascara sagrada bark, and in common with other species of rhamnus it possesses cathartic properties in a marked degree. Its specific use is in the treatment of rheumatism. A fluid extract is now prepared by several manufacturing drug houses in the United States , which possesses the qualities of the crude product to a moderate extent. The dose of the decoction varies from a tablespoonful to five or six ounces; of the fluid extract, from fifteen drops to a drachm. Introduced by the author as a specific for rheumatism in the July number of the Eclectic Medical Journal , for 1895.
Use: It is a bitter tonic that has a direct influence on the stomach and intestines. Its action is on the vasomotor system, increasing secretion of the intestinal tract and increasing peristaltic action, thus restoring normal activity. As it influences the venous and capillary circulation of the intestinal tract it is a remedy that acts favorably in hemorrhoids. Cascara is not a harmful cathartic; but has a tendency to restore normal action,and for this reason, is of great value in chronic constipation. It is best to give it in small doses first and gradually increase;then when stool becomes normal continue the last dose for a week or so and then gradually decrease dose and give at longer intervals. Given in this way it has proved to be a valuable remedy in chronic constipation , chronic indigestion,gastric or intestinal catarrh and in the temporary constipation of pregnancy. It should not be given in so large doses as to produce pain or gripping.
Habitual constipation, with atonic condition of the intestinal tract. Rhamnus purshiana is a mild laxative.
1911: LLOYD: RHAMNUS (RHAMNUS PURSHIANA, U.S.P.)
Rhamnus catharticus (Buckthorn) is one of wide distribution, prevailing over Northern Africa, most of Europe, the Caucasus, and into Siberia . In some instances it becomes almost a small tree, Fluckiger having a specimen 8 inches in diameter. It was known as a laxative before the Norman Conquest, being called Waythorn or Hartshorn. The Welsh physicians of the 13th century (507) prescribed the berries, under the name Syrup of Buckthorn, a title which, recognized by all writers on domestic or official medicine, still prevails. In the London Pharmacopeia, 1650, this syrup, aromatized, became official.
The official drug of the Pharmacopeia ( Rhamnus purshiana) is not only related botanically to the above, but is therapeutically similar, being laxative in small doses and cathartic in large doses. The tree (Rhamnus purshiana) is distributed over the mountain ranges of the Western Pacific States, being most abundant in California and Oregon . Possibly collectors do not distinguish between this species and Rhamnus californica. To the settlers of that region it has long been known as Chittim wood, an infusion of the bark being used as a cathartic.
Dr. J.H. Bundy, an Eclectic physician of Colusa , California , impressed with its valuem, brought the bark, under the name, Cascara Sagrada, to the attention of Parke, Davis & Co., of Detroit , Michigan . This energetic firm introduced it in 1877, through the columns of their publication, New Preparations, (1877 and 1878).
The remedy became a great favorite, and within a reasonable period was in demand throughout the civilized world, becoming official in Pharmacopeia of the United States , 1890.
The remarkable record of this drug has been a subject of many contributions to botanical and therapeutical literature, much of interest even now remaining unwritten. To this writer its journey from the aborigines to scientific use and therapeutic study appears to parallel the course of such drugs as coca, jalap, benzoin, sassafras, croton tiglium, etc.
Summary. To Dr. J.H. Bundy, Colusa , California , 1877, is due the credit of introducing the bark of Rhamnus Purshiana (Cascara Sagrada) to the medical profession.
To “New Preparations,” Parke, Davis & Co., of Detroit , Michigan , (1877 and 1878) is due the credit of bringing the drug to the attention of physicians and pharmacists. The firm of Parke, Davis & Co. introduced to the world the preparations of this drug, of which they were, for some years, the sole manufacturers.
A descriptive treatise that will record some unwritten phases of its dramatic history, familiar only to those concerned in its introduction, should not be lost to posterity. The following, contributed by this writer to the Research Committee of the American Pharmaceutical Association (vol. 44, 1896) is a brief summary.
1895: Watkins: CASCARA SAG:
Constipation due to nervous an dmuscular atony of the lower bowel, with diminished sensibility, constipation due to neglect. Ten to thirty drops three times a day.
1898; Webster; (Muscles) – Cascara Sagrada
Considerable ado was made over this remedy as an agent for the successful treatment of rheumatism a few years ago, but it seems to have been weighed in the balance later and found wanting. At least I think it has failed to fulfil the expectations that the first reports of its action in this direction warranted, as it is seldom mentioned in this connection at present. I have never been able to derive any decided benefit from it in the treatment of rheumatism, though I have tried it several times in cases offering favorable opportunities for a response in the affirmative. Possibly I have not happened to test it in the proper cases, however.
In 1888, Dr. A. T. Goodwin (N. Y. Medical Journal ) reported remarkable success in his own case and several others with the agent under consideration. In his own case he took cascara as a laxative while suffering from severe rheumatic pains in the shoulder, and recovered entirely from pain within two days. From this time he employed the remedy extensively in both hospital and private practice with flattering success. This is worthy of remembrance at least.
He used from ten to fifteen drops of the fluid extract three or four times daily.
Cascara Amarga, sometimes known as Honduras Bark, is advised in syphilis as an active alterative. The line of its action is where there is chronic skin affection or where the pustular variety of the syphiloderm prevails, the conditions being induced by debility, thus needing a specific tonic influence. It soothes the stomach, overcomes sensitiveness or ready irritability of this organ, increases the appetite, and improves general tonicity.
CASCARILLA (U.S.P.) – CASCARILLA
1909: Felter and Lloyd: CASCARILLA (U.S.P.) – CASCARILLA
History - The tree from which cascarilla is obtained is a native of the West Indies, and is found plentifully in the island of Eleutheria , from which it derives its name. It was, for a time, supposed to have been derived from the Croton Cascarilla, a small tree growing in the Bahamas , Hayti , Peru , and Paraguay , but this is now ascertained by botanists to have been an error. Cascarilla bark is imported from the Bahama Islands, Jamaica , etc. At one time it was known as China nova, on account of the resemblance of the external portion of the bark to that of cinchona, the latter having been adulterated and even substituted with cascarilla bark. The name China nova was subsequently applied to the bark of Beuna magnifolia, Weddell, a South American tree, noted for the magnificence of its foliage and the fragrance of its flowers (Pharmacographia). Our Pharmacopoeial name – Cascarilla – is scarcely known in the Bahama Isles, the drug being there known as Eleutheria, or Sweet-wood bark. The name Cascarilla was first used in connection with cinchona bark, to which, by priority, it should apply, but it is now applied wholly to the sweet-wood bark. It signifies (Spanish) “little bark” (Ibid).
Action, Medical Uses, and Dosage - Tonic and stimulant. Used in dyspepsia, flatulency, chronic diarrhoea, in debility attending chronic diseases, convalescence from acute diseases, and to arrest vomiting. When cinchona produces nausea, the addition of cascarilla will prevent it. Dose of the powder, from 20 to 40 grains; of the tincture, from 1 to 4 fluid drachms; of the infusion, from 1 to 4 fluid ounces. On account of its musky odor, it is a common ingredient of fumigating pastiles.
Buckthorn, Rhamnus frangula , grows in wet places throughout Europe, Siberian Asia, and the Northern African Coast . From a very early date it has been known as a cathartic as well as a coloring agent. A decoction of the bark has been in domestic use both as a dye for cotton, wool, and silk fabrics, and as a cathartic, in which (latter) direction it is very effective. No written professional record antedates its domestic use, and perhaps as a “rheumatic remedy” it has no domestic superior.
Rhamnus catharticus (buckthorn berries) was official in 1820, 1828 (2d ed. of 1820), and the New York edition of 1830. It was then dropped altogether until 1890, when Rhamnus Purshiana was made official, with the secondary title, Cascara Sagrada. The 1900 edition followed that of 1890. In 1910 the title Cascara Sagrada was made official, Rhamnus Purshiana being mentioned only as the botanical name of the tree yielding the drug.
Rhamnus, buckthorn, is of wide distribution. The variety catharticus, formerly used in medicine, prevails over Northern Africa, most of Europe, the Caucasus, and into Siberia . In some instances it becomes almost a small tree, Fluckiger (240) having a specimen eight inches in diameter. Before the Norman Conquest buckthorn was known as a laxative, under the name Waythorn of Hartshorn. The Welsh physicians of the 13th century (507) prescribed a preparation of the berries under the name Syrup of Buckthorn, a title that still prevails. This syrup, aromatized, became official in the London Pharmacopeia, 1650.
Rhamnus Purshiana. – The present official drug of the Pharmacopeia, Rhamnus Purshiana, is not only related botanically to the earlier variety, but it is therapeutically similar, being laxative in small doses and cathartic in large doses. The tree (R. Purshiana), is distributed over the mountain ranges of the western Pacific states, being most abundant in California and Oregon . Possibly collectors do not always distinguish between this species and Rhamnus californica. To the settlers of the west it has long been known as “Chittim wood,” and by them an infusion of the bark is used as a cathartic.
Dr. J. H. Bundy (111a), of Colusa , California , impressed with its value, brought the bark, under the name Cascara Sagrada, to the attention of Parke, Davis & Co., of Detroit , Michigan . This firm introduced it in 1877, through the columns of their publication, New Preparations, (467), 1877 and 1878.
The remedy became a great favorite, and within a reasonable time was in demand throughout the civilized world, becoming official in the Pharmacopeia of the United States in 1890. The remarkable record of rhamnus has been a subject of many contributions to botanical and therapeutic literature, and much of interest concerning it remains yet unwritten. To this writer its journey from the aborigines to scientific use and systematic therapeutic study appears to parallel the course of such drugs as coca, jalap, benzoin, sassafras, cinchona and Croton Tiglium.
A descriptive treatise, recording some previously unwritten phases of the dramatic history of rhamnus, familiar only to thise concerned in its introduction, was contributed by this writer, *1 in 1896, to the Research Committee of the American Pharmaceutical Association. From this we take the following brief summary:
“In a paper contributed to New Preparations, *2 October 15, 1877, p. 8, the late Dr. J. H. Bundy, of Colusa, California, commended ‘Cascara Sagrada’ as a valuable remedy in the treatment of constipation. This notice was by means of a brief note that was part of a paper on Berberis aquifolium, Dr. Bundy promising, however, to give the subject further attention later. Dr. Bundy says:
“It is not my purpose to treat on Cascara Sagrada in this paper, but using it in connection with the Berberis, I simply make mention of it. In the future I will introduce the drug to the profession.”
This, so far as the writer can determine, was the first reference concerning this remedy in pharmaceutical or medical print. Agreeably to promise, in January, 1878, Dr. Bundy contributed to New Preparations a paper on “Cascara Sagrada,” in which he gave the uses of the fluid extract of that remedy. Following this came many papers from Dr. Bundy and other physicians, twenty contributions on the subject being printed in New Preparations, 1878, the subject being confined to this publication during 1877 and 1878. Dr. Bundy stated in his paper, 1878, as follows: “A description of the Cascara I am unable to give at this time, but suffice it to say that it is a shrub, and in due time its botanical name will be known.” Dr. Bundy neglected, however, to concern himself further in the matter.
In the fall of 1878, Dr. C. H. Adair, of Colusa , California , a partner of Dr. Bundy, sent to this writer specimens of the bark, and botanical specimens of the tree yielding it. These were identified by Mr. Curtis G. Lloyd as Rhamnus Purshiana. This fact was announced in a paper titled “Some Specimens of Western Plants,” presented to the American Pharmaceutical Association at its meeting in Atalnta , Georgia , November, 1878, (Proceedings, 1879, p. 707), and completed the drug’s history.
NAMES. – Dr. Bundy supplied the drug under the Spanish name “Cascara Sagrada,” a term said to have been in local use throughout some sections of California . This came to be the common name of the drug, and will surely dominate all others as long as the drug is in use. The anglicized name, “Sacred Bark,” has also been applied to the drug, the Scriptural term “Chittim bark” being also employed in early days in some parts of California . These last names are now obsolete.
At the present date, this drug is employed in every civilized country and is recognized in medical, pharmaceutical, and chemical literature the world over. To give detailed references to it would require a volume in space.
The pharmacy and chemistry of cascara sagrada is now voluminous, its record lying in the field of Dr. Waldbott and Prof. Heyroth. References thereto are recorded in the contribution of Dr. Dohme (Proc. Amer. Pharm. Assn., 1897, pp. 193-202), entitled “The Chemistry of Cascara Sagrada,” together with references to works of previous investigators. Dr. Dohme’s results are not susceptible of satisfactory condensation, especially as he includes and contrasts therewith constituents obtained from buckthorn. In 1898, in connection with Dr. Hermann Engelhardt, Dr. Dohme continued the study of cascara sagrada, under the title “The Bitter Principle of Cascara Sagrada,” announcing that it was but a preliminary contribution that would be continued in the future. (See Proc. Amer. Pharm. Assn., 1898, p. 340,341). Although our study is restricted to crude drug history, the innovation made in the direction of the articles by Dr. Dohme concerning the structures of these two drugs can not come amiss to one concerned in the subject as a whole. *3
*1 – Introductory to a contribution from chemical investigations of Rhamnus Purshiana, undertaken by Alfred R. L. Dohme (175a).
*2 – New Preparations, Detroit , Mich. Parke, Davis & Co. (467).
*3 – See “Monographs from the Research Laboratory of Sharp and Dohme, The History, Pharmacognosy, and Chemistry of Cascara Sagrada.”