_Ipecacuanha Root_, _Ipecacuan_; F. _Racine d’Ipécacuanha annelee_; G.
_Brechwurzel_.
=Botanical Origin=—_Cephaëlis[1373] Ipecacuanha_ A. Richard—This is a
small shrub, 8 to 16 inches high, with an ascending, afterwards erect,
simple stem, and somewhat creeping root, growing socially in moist
and shady forests of South America, lying between 8° and 22° S. lat.,
especially in the Brazilian provinces of Pará, Maranhão, Pernambuco,
Bahia, Espiritu Santo, Minas, Rio de Janeiro, and São Paulo. Within the
last half century, it has been discovered in the vast interior province
of Matto Grosso, chiefly in that part of it which forms the valley of
the Rio Paraguay. From information given to Weddell,[1374] it would
seem probable that the plant extends beyond the frontiers of Brazil to
the Bolivian province of Chiquitos.
The root which is brought into commerce is furnished chiefly by the
region lying between the towns of Cuyabá, Villa Bella, Villa Maria, and
Diamantina in the province of Matto Grosso; but to some extent also by
the woods in the neighbourhood of the German colony of Philadelphia on
the Rio Todos os Santos, a tributary of the Mucury, north of Rio de
Janeiro.
Prof. Balfour of Edinburgh, who has paid much attention to the
propagation of ipecacuanha, finds that the plant exists under two
varieties, of which he has published figures;[1375] they may be thus
distinguished:
_a._ Stem woody, leaves of firm texture, elliptic
or oval, wavy at the edges, with but few hairs on
surface and margin. Long in cultivation: origin unknown.
_b._ Stem herbaceous, leaves less firm in texture,
more hairy on margin, not wavy. Grows in the neighbourhood
of Rio de Janeiro.
The plant cultivated in India seems disposed to run into several
varieties, but according to the experience gained in Edinburgh, the
diversity of form apparent in young plants tends to disappear with age.
=History=—In an account of Brazil, written by a Portuguese friar, who,
it would seem, had resided in that country from about 1570 to 1600, and
published by Purchas,[1376] mention is made of three remedies for the
bloody flux, one of which is called _Igpecaya_ or _Pigaya_; the drug
here spoken of is probably that under notice.
[1373] I am informed by my friend Professor Müller of Geneva that in
describing the Rubiaceæ for the _Flora Brasiliensis_ he will include
Cephaëlis Ipecacuanha in the genus _Mapouria_.—F. A. F.. March 1879.
[1374] _Ann. des Sciences nat._ Bot. xi. (1849) 193-202.
[1375] _Trans. of Roy. Soc. of Edinb._ xxvi. (1872) 781. plates
31-32.—Fig. in Bentley and Trimen, _Med. Plants._ part 15 (1876).
[1376] Purchas, _His Pilgrimes_, Lond. iv. (1625),—a treatise of
Brasill, written by a Portugall which had long lived there, p. 1311.
Piso and Marcgraf[1377] in their scientific exploration of Brazil
met with two kinds of ipecacuanha; the one provided with a brown
root is Cephaëlis Ipecacuanha, which they figured. The root of the
other variety, which they called _Ipecacuanha blanca_, is that of
Richardsonia scabra (see page 376 below). Piso and Marcgraf described
the virtues of these roots, apparently supposing them to be much the
same as to their action. Although in common use in Brazil, ipecacuanha
was not employed in Europe prior to the year 1672. At that date, a
traveller named Legras brought from South America a quantity of the
root to Paris, some of which came into the possession of the “maître
appoticaire” Claquenelle.[1378] It would appear that the root was
prescribed from the latter by Legras (said to have been himself
acquainted with the practice of medicine[1379]), and also by Jean
Adrien Helvetius, a young Dutch physician, then living in Paris. Yet no
success at first was obtained, the drug being administered in too large
doses. In 1680, a merchant of Paris named Garnier became possessed of
150 lb. of ipecacuanha, the valuable properties of which in dysentery
he vaunted to his medical attendant Afforty, and to Helvetius. Garnier
on his convalescence[1380] made a present of some of the new drug to
Afforty, who attached to it but little importance. Helvetius, on the
other hand, was induced to prescribe the root in cases of dysentery,
which he did with the utmost success. It is stated by Eloy that
Helvetius even caused placards to be affixed to the corners of the
streets (about the year 1686), announcing his successful treatment
with the new drug, supplies of which he obtained through Garnier from
Spain, and sold as a secret medicine. The fame of the cures effected by
Helvetius reached the French Court, and caused some trials of the drug
to be made at the Hôtel Dieu. These having been fully successful, Louis
XIV. accorded to Helvetius the sole right of vending his remedy.[1381]
Subsequently several great personages, including the Dauphin of France,
having experienced its benefit, the king consulted his physician,
Antoine d’Aquin, and the well-known Jesuit Père François de Lachaise,
who had become the King’s confessor in 1675. Through them was chiefly
negotiated the purchase from Helvetius of his secret, for 1000 louis
d’or, and made public in 1688. The right of Helvetius to this payment
was disputed in law by Garnier, but maintained by a decision of the
Châtelet of Paris.[1382]
The botanical source of ipecacuanha was the subject of much dispute
until finally settled by Antonio Bernardino Gomez, a physician of the
Portuguese navy, who brought authentic specimens from Brazil to Lisbon
in the year 1800.[1383]
[1377] _Hist. nat. Brasil._ 1648. Piso, p. 101, Marcgraf, p. 17.
[1378] Pomet, _Histoire générale des Drogues_, i. (1694) 47.
[1379] Mérat and De Lens, _Dict. de Mat. Méd._ iii. (1831) 644, call
Legras a physician, and say that Garnier brought himself the 150 lb.
from abroad.
[1380] Eloy, _Histoire générale de la Médecine_. Mons. ii. (1778)
485, mentions a _sick druggist_, who presented Helvetius with
the ipecacuanha. Garnier, according to Eloy, was a “Marchand
chapelier.”—Leibnitz, in _Ephemerid. Academ. Cæsareo-Leopold_, 1696,
Appendix, p. 6, miscalled the merchant Grenier.
[1381] An abstract of the royal patent is given by Leibnitz, _l. c._ 20
(date not added).
[1382] On the history of ipecacuanha, consult also Sprengel,
_Geschichte der Arzneykunde_, iv. (1827) 542.—We have not seen the
pamphlet quoted by Haller, _Bibl. bot._ ii. 17: Helvetius, _Usage de
l’Hipecacoanha_. 4° (no date).
[1383] _Trans. of Linn. Soc._ vi. (1801) 137.
=Collection=[1384]—The ipecacuanha plant, _Poaya_ of the Brazilians,
grows in valleys, yet prefers spots which are rather too much raised
to be inundated or swampy. Here it is found under the thick shade of
ancient trees growing mostly in clumps. In collecting the root, the
_poayero_, for so the collector of _poaya_ is called, grasps in one
handful if he can, all the stems of a clump, pushing under it obliquely
into the soil a pointed stick to which he gives a see-saw motion. A
lump of earth enclosing the roots is thus raised; and, if the operation
has been well performed, those of the whole clump are got up almost
unbroken. The _poayero_ shakes off adhering soil, places the roots in a
large bag which he carries with him, and goes on to seek other clumps.
A good collector may thus get as much as 30 lb. of roots in the day;
but generally a daily gathering does not exceed 10 or 12 lb., and there
are many who scarcely get 6 or 8 lb. In the rainy season, the ground
being lighter, the roots are removed more easily than in dry weather.
The _poayeros_, who work in a sort of partnership, assemble in the
evening, unite their gatherings, which having been weighed, are spread
out to dig. Rapid drying is advantageous; the root is therefore exposed
to sunshine as much as possible, and if the weather is favourable, it
becomes dry in two or three days. But it has always to be placed under
cover at night on account of the dew. When quite dry, it is broken into
fragments, and shaken in a sieve in order to separate adherent sand and
earth, and finally it is packed in bales for transport.
The harvest goes on all the year round, but is relaxed a little during
the rains, on account of the difficulty of drying the produce. As
fragments of the root grow most readily, complete extirpation of the
plant in any one locality does not seem probable. The more intelligent
_poayeros_ of Matto Grosso are indeed wise enough intentionally to
leave small bits of root in the place whence a clump has been dug, and
even to close over the opening in the soil.
=Cultivation=—The importance in India of ipecacuanha as a remedy for
dysentery, and the increasing costliness of the drug,[1385] have
occasioned active measures to be taken for attempting its cultivation
in that country. Though known for several years as a denizen of
botanical gardens, the ipecacuanha plant has always been rare, owing to
its slow growth and the difficulty attending its propagation.
It was discovered in 1869 by McNab, curator of the Botanical Garden
of Edinburgh, that if the annulated part of the root of a growing
ipecacuanha plant be cut into short pieces even only ¹/₁₆ of an inch
thick, and placed in suitable soil, each piece will throw out a
leaf-bud and become a separate plant. Lindsay, a gardener of the same
establishment, further proved that the petiole of the leaf is capable
of producing roots and buds, a discovery which has been utilized in the
propagation of the plant at the Rungbi Cinchona plantation in Sikkim.
[1384] Abstracted from the interesting eye-witness account of Weddell,
_l. c._
[1385] The following are the average prices at which the drug was
purchased wholesale, in London during three periods of ten years each:—
10 years ending 1850, average price 2_s._ 9½_d._ per lb. 10 ” 1860, ”
6_s._ 11½_d._ ” 10 ” 1870, ” 8_s._ 8¼_ d._ ”
In 1871, well-formed fruits were obtained from the ipecacuanha
plants growing in the Edinburgh Botanical Garden: this was promoted
by artificial fertilization, especially when the flowers of a plant
producing _long styles_ were fertilized with the pollen of one having
_short_ styles,—for _Cephaëlis_ like _Cinchona_ has dimorphic flowers.
With regard to the acclimatization of the plant in India, much
difficulty has been encountered, and successful results are still
problematical. The first plant was taken to Calcutta by Dr. King in
1866, and by 1868 had been increased to nine; but in 1870-71, it
was reported that, notwithstanding every care, the plants could not
be made to thrive. Three plants which had been sent to the Rungbi
plantation in 1868, grew rather better; and by adopting the method of
root propagation, they were increased by August 1871, to 300. Three
consignments of plants, numbering in all 370, were received from
Scotland in 1871-72, besides a smaller number from the Royal Gardens,
Kew. From these various collections, the propagation has been so
extensive, that on 31 March 1873, there were 6,719 young plants in
Sikkim, in addition to about 500 in Calcutta, and much more in 1874.
The ipecacuanha plant in India has been tried under a variety of
conditions as regards sun and shade, but thus far with only a moderate
amount of success. The best results are those that have been obtained
at Rungbi, 3000 feet above the sea, where the plants, placed in
glazed frames, were reported in May 1873 as in the most healthy
condition.[1386]
=Description=—The stem creeps a little below the surface of the soil,
emitting a small number of slightly branching contorted roots, a few
inches long. These roots when young are very slender and thread-like,
but grow gradually knotty and become by degrees invested with a very
thick bark, transversely corrugated or ringed. Close examination of the
dry root shows that the bark is raised in narrow warty ridges, which
sometimes run entirely round the root, sometimes encircle only half
its circumference. The whole surface is moreover minutely wrinkled
longitudinally. The rings or corrugations of a full sized root number
about 20 in an inch; not unfrequently they are deep enough to penetrate
to the wood.
The root attains a maximum diameter of about ²/₁₀ of an inch; but as
imported, a large proportion of it is much smaller. The woody central
part is scarcely ¹/₂₀ of an inch in diameter, subcylindrical, sometimes
striated, and devoid of pith.
Ipecacuanha is of a dusky grey hue, occasionally of a dull ferruginous
brown. The root is hard, breaks short and granular (not fibrous),
exhibiting a resinous, waxy, or farinaceous interior, white or greyish.
The bark, which constitutes 75 to 80 per cent. of the entire root, may
be easily separated from the less brittle wood. It has a bitterish
taste and faint, musty smell; when freshly dried it is probably much
more odorous. The wood is almost tasteless. In the drug of commerce
the roots are always much broken, and there is often a considerable
separation of bark from wood; portions of the non-annulated, woody,
subterraneous stem are always present.
[1386] _Annual Report of the Royal Botanical Gardens_, Calcutta, 31 May
1873—from which we have abstracted many of the foregoing particulars.
The report for 1876-1877 is by no means favourable to the prospects of
Cephaëlis in India.
During the last few years there has been imported into London a
variety of ipecacuanha, distinguished as _Carthagena_ or _New Granada
Ipecacuanha_, and differing from the Brazilian drug chiefly in being of
larger size. Thus, while the maximum diameter of the annulated roots of
Brazilian ipecacuanha is about ²/₁₀ of an inch, corresponding roots of
the New Granada variety attain nearly ³/₁₀. The latter, moreover, has a
distinct radiate arrangement of the wood, due to a greater developement
of the medullary rays, and is rather less conspicuously annulated.
Lefort (1869) has shown that the New Granada drug is a little less rich
in emetine than the ipecacuanha of Brazil.
Mr. R. B. White, of Medellin in the valley of the Cauca, New Granada,
near which place the drug has been collected, has been good enough to
send us herbarium specimens of the plant with roots attached; they
agree entirely with _Cephaëlis Ipecacuanha_.
=Microscopic Structure=—The root is coated with a thin layer of brown
cork-cells; the interior cortical tissue is made up of a uniform
parenchyme, in which medullary rays cannot be distinguished. In the
woody column they are obvious; the prevailing tissue consists of short
pitted vessels. The cortical parenchyme and the medullary rays are
loaded with small starch granules. Some cells of the interior part of
the bark contain however only bundles of acicular crystals of oxalate
of calcium.
=Chemical Composition=—The peculiar principles of ipecacuanha are
_Emetine_ and _Ipecacuanhic Acid_, together with a minute proportion of
a fœtid volatile oil. The activity of the drug appears to be due solely
to the alkaloid, which taken internally is a potent emetic.
Emetine, discovered in 1817 by Pelletier and Magendie, is a bitter
substance with distinct alkaline reaction, amorphous in the free state
as well as in most of its salts; we have succeeded in preparing a
crystallized hydrochlorate.
The root yields of the alkaloid less than 1 per cent.; the numerous
higher estimates that have been given relate to impure emetine, or have
been arrived at by some defective methods of analysis.[1387]
[1387] See the results obtained by Richard and Barruel, by Magendie and
Pelletier, and by Attfield, as recorded by the last named chemist in
_Proceedings of the British Pharmaceutical Conference_ for 1869. 37-39.
The formula assigned to emetine by Reich (1863) was C₂₀H₃₀N₂O, that
given by Glénard (1875) C₁₅H₂₂NO₂, and lastly that found in 1877 by
Lefort and F. Würtz, C₂₈H₄₀N₂O₅.
The alkaloid may be obtained by drying the powdered bark of the root
with a little milk of lime, and exhausting the mixture with boiling
chloroform, petroleum-benzin or ether. It is a white powder turning
brown on exposure to light and softening at 70° C. Emetine assumes
an intense and permanent yellow colour with solution of chlorinated
lime and a little acetic acid, as shown by Power (1877). A solution
containing but ¹/₆₀₀₀ of emetine still displays that reaction. We
found the alkaloid to be destitute of rotatory power, at least in the
chloroform solution.
The above reactions may be easily shown thus:—Take 10 grains of
powdered ipecacuanha, and mix them with 3 grains of quicklime and a few
drops of water. Dry the mixture in the water bath and transfer it to a
vial containing 2 fluid drachms of chloroform: agitate frequently, then
filter into a capsule containing a minute quantity of acetic acid,
and allow the chloroform to evaporate. Two drops of water now added
will afford a nearly colourless solution of emetine, which, placed in
a watch-glass, will readily give amorphous precipitates upon addition
of a saturated solution of nitrate of potassium, or of tannic acid, or
of a solution of mercuric iodide in iodide of potassium. To the nitrate
Power’s test may be further applied.
If the _wood_ separated as exactly as possible from the bark is used,
and the experiment performed in the same way, the solution will reveal
only traces of emetine. By addition of nitrate of potassium, no
precipitate is then produced, but tannic acid or the potassico-mercuric
iodate afford a slight turbidity. This experiment confirms the
observation that the bark is the seat of the alkaloid, as might indeed
be inferred from the fact that the wood is nearly tasteless.
_Ipecacuanhic Acid_, regarded by Pelletier as gallic acid, but
recognised in 1850 as a peculiar substance by Willigk,[1388] is
reddish-brown, amorphous, bitter, and very hygroscopic. It is related
to caffetannic and kinic acids; Reich has shown it to be a glucoside.
Ipecacuanha contains also, according to Reich, small proportions of
resin, fat, albumin, and fermentable and crystallizable sugar; also gum
and a large quantity of pectin. The bark yielded about 30 per cent.,
and the wood more than 7 per cent. of starch.
=Commerce=—The imports of ipecacuanha into the United Kingdom in 1870
amounted to 62,952 lb., valued at £16,639.[1389]
=Uses=—Ipecacuanha is given as an emetic, but much more often in small
doses as an expectorant and diaphoretic. In India it has proved of
late a most important remedy for dysentery. Since the year 1858 when
the administration of ipecacuanha in large (30 grains) doses began to
be adopted, the mortality in the cases treated for this complaint has
greatly diminished.[1390]
=Adulteration and Substitutes=—It can hardly be said that ipecacuanha
as at present imported is ever adulterated. Although it may contain
an undue proportion of the woody stems of the plant, it is not
fraudulently admixed with other roots. But it very often arrives much
deteriorated by damp: we have the authority of an experienced druggist
for saying that at least three packages out of every four offered in
the London drug sales, have either been damaged by sea-water or by damp
during their transit to the coast.
Several roots have been described as _False Ipecacuanha_, but we know
not one that would not be readily distinguished at first sight by any
druggist of average knowledge and experience.
In Brazil the word _Poaya_ is applied to emetic roots of plants of at
least six genera, belonging to the orders _Rubiaceæ_, _Violarieæ_, and
_Polygaleæ_; while in the same country, the name _Ipecacuanha_ is used
for various species of _Ionidium_[1391] as well as for _Cephaëlis_.
[1388] Gmelin, _Chemistry_, xv. (1862) 523.
[1389] _Annual Statement of the Trade and Navigation of the U.K. for
1870._—The more recent issues of this return have been simplified to
such an extent that drugs are for the greater part included under one
head.
[1390] In the Madras Presidency, the death-rate from dysentery was
71 per 1000 cases treated: under the new method of treatment, it has
been reduced to 13·5. In Bengal it has fallen from 88·2 to 28·8 per
1000.—_Supplement to the Gazette of India_, January 23, 1869.
[1391] As _Ionidium Ipecacuanha_ Vent., _I. Poaya_ St. Hil., _I.
parviflorum_ Vent., the first of which affords the _Poaya branca_
or _White Ipecacuanha_ of the Brazilians.—See C.F.P. von Martius,
_Specimen Mat. Med. Bras._ 1824; A. de St. Hilaire, _Plantes usuelles
des Brésiliens_, 1827-28.
Some of these roots, which are occasionally brought to Europe under the
notion that they may find a market, have been described and figured by
pharmacologists. We shall notice only the following:—
1. _Large Striated Ipecacuanha_—This is the root of _Psychotria
emetica_ Mutis (_Rubiaceæ_), a native of New Granada. It is
considerably stouter than true ipecacuanha, but consists like the
latter of a woody column covered with a thick brownish bark. The
latter, though marked here and there with constrictions and fissures,
is not annulated like ipecacuanha, but has very evident longitudinal
furrows. But its most remarkable character is that it remains _soft and
moist, tough to the knife_, even after many years; and the cut surface
has a dull violet hue. The root has a sweetish taste and abounds in
sugar;[1392] its decoction is not rendered blue by iodine, nor is any
starch to be detected by means of the microscope. The drug occasionally
appears in the London market.
2. _Small Striated Ipecacuanha_—This drug in outward appearance closely
resembles the preceding, but is usually of smaller size, sometimes
much smaller and in short pieces tapering towards either end. It also
differs in being brittle, abounding in starch, and having its woody
column provided with numerous pores, easily visible under a lens. Prof.
Planchon[1393] of Paris, who has particularly examined both varieties
of Striated Ipecacuanha, is of opinion that the drug under notice may
be derived from some species of _Richardsonia_.
3. _Undulated Ipecacuanha_—The root thus called is that of _Richardia
scabra_ L. (_Richardsonia scabra_ St. Hilaire), a plant of the same
order as _Cephaëlis_, very common in Brazil, where it grows in
cultivated ground and sandy places, or by roadsides, and even in
the less frequented streets of Rio de Janeiro. Authentic specimens
have been forwarded to us by Mr. Glaziou of Rio de Janeiro, and Mr.
J. Correa de Méllo of Campinas; and we have also had ample supplies
of the plant cultivated by us near London and at Strassburg, where
Richardsonia succeeds in the open air.
The root in the fresh state is pure white, but by drying becomes of
a deep iron-grey. In the Brazilian specimens, there is a short crown
emitting as many as a dozen prostrate stems; below this there is
generally, as in true ipecacuanha, a naked woody portion, which extends
downwards into a thicker root, ²/₁₀ of an inch in diameter, and six
or more inches long. This part of the root is marked by deep fissures
on alternate sides, which give it a knotty, sinuous, or undulating
outline. It has a brittle, very thick bark, white and farinaceous
within, surrounding a strong flexible slender woody column. The root
has an earthy odour not altogether unlike that of ipecacuanha, and a
slightly sweet taste. It affords no evidence of emetine when tested
in the manners described at p. 374, and can therefore easily be
distinguished from the true drug.
[1392] Attfield in _Pharm. Journ._ xi. (1870) 140.
[1393] _Journ. de Pharm._ xvi. (1872) 405: xvii. 19.