PIPER METHYSTICUM.—KAVA-KAVA. Action, Medical Uses, and Dosage

The root of Piper methysticum has a pleasant, somewhat lilac odor, and a slightly pungent, bitter and astringent taste, which augments the salivary discharge. It has marked general and local anæsthetic properties. It has been employed as a pleasant remedy in bronchitis, rheumatism, gout, gonorrhœa, and gleet, and has also been recommended as a powerful sudorific. It appears to exert its influence more especially upon diseased mucous membranes, and may be found useful in chronic catarrhal affections of various organs, and in chronic inflammation of the neck of the bladder. The action of the root varies, according to the amount taken; in small doses, it is tonic and stimulant; while in large doses it produces an intoxication, which, unlike that from alcohol, is of a reserved, drowsy character, and attended with confused dreams. The natives who use its infusion as an intoxicating beverage for a considerable length of time, are said to become affected with a dry, scaly, cracked, and ulcerated skin, and vision becomes more or less obscured. According to Kesteven, leprous ulcerations may be produced by its habitual use. M. Dupouy, who has given considerable attention to the therapeutical virtues of this drug, arrives at the following conclusions: Given in drink, kava is a sialagogue, but is not sudorific. In medicinal doses, it acts upon the stomach, similar to the bitter stimulants, increasing the appetite, without occasioning diarrhœa or constipation, and may prevent catarrhal affections of this portion of the digestive tube. It exerts a special stimulation upon the central nervous system, differing essentially from ethylic intoxication; and, as its taste is agreeable, one soon becomes a proselyte to it. It has a very powerful action upon aqueous diuresis, and may be classed among the most efficient diuretics. It does not occasion priapism, but, on the contrary, antagonizes it. It is endowed with remarkable and prompt blennostatic properties, augmenting the discharge previous to effecting its cure. It is of undoubted efficiency in acute vaginitis or urethritis, allaying the inflammation, causing the pain during micturition to disappear, when dysuria is present, and suppressing the muco-purulent catarrh from the vesico-urethral mucous membrane. It has, over other blennostatic agents, the marked advantages of being pleasant to take, of augmenting the appetite, of occasioning neither diarrhœa nor constipation, of alleviating or entirely subduing pain during urination, of completely changing the character of the discharge, and of effecting the cure in a very short time—10 or 12 days. He can not too highly recommend its employment, especially in the treatment of gonorrhœa. Ellingwood (Mat. Med., 1898) declares it of great value in subacute and slow forms of gonorrhœa, and especially in gleet. It is a remedy for nocturnal incontinence of urine in the young and old, when due most largely to muscular weakness.