RHAMNUS PURSHIANA (U. S. P.)—CASCARA SAGRADA. Action, Medical Uses, and Dosage

Cascara sagrada, 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 dyspeptic 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, while 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 diarrhœa, 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.