IPECACUANHA. The root used in medicine under this name is obtained from Gephaelis Ipecacuanha, A. Rich., a small shrubby plant of the natural order Cincho-nacese. It is a native of Brazil, growing in clumps or patches in moist shady forests from 8° to 22° S. lat., and is believed to extend to the Bolivian province of Chiquitos, and the valley of Cauca in New Granada. The drug of commerce is procured chiefly from the region lying between the towns of Cuyaba, Villa Bella, Villa Maria, and Diamantina in the province of Matto Grosso, and near the German colony of Philadelphia, north of Rio Janeiro. Ipecacuanha, although in common use in Brazil, was not previous to 1672. In France within a few years after that date it formed the chief ingredient in a remedy for dysentery, the secret of the composition of which was purchased by the French Government for 1000 louis d'or, and made public in 1688. The botanical source of ipecacuanha was not accurately known until 1800.
The mode of obtaining the root is thus described by Weddell. The collector or poayero grasps the whole of the stems of the poaya or ipecacuanha plant in one hand, and loosens the roots by inserting a stick obliquely under them, to which is given a see-saw motion; the adhering soil is then shaken off, and the root placed in a bag. A poayero collects on the average about 10 to 12 lb of the root in a day, but sometimes as much as 30 fi>, or as little as 6 lb or 8 lb. The root requires to be dried rapidly; it is therefore spread out in the sunshine as much as possible, and at night is covered over to shield it from the dew. In about three days, under favourable circumstances, it becomes dry, and is then broken up, sifted to remove sand or dirt, and packed in " serons," or bales made of cowhide.
The root is gathered during the whole of the year, but in less quantity during the rainy season on account of the difficulty of drying the root. As imported, about three packages out of four are damaged by sea-water or damp. The root appears to be possessed of very great vitality, for in 1869 M'Nab, the late curator of the Botanical Gardens of Edinburgh, discovered that so small a portion as ^ of an inch, of the annulated root, placed in suitable soil, would throw out a leaf-bud and develop into a fresh plant, while Lindsay, a gardener in the same establishment, proved that even the leaf-stalk is capable of producing roots and buds ; hence there is but little probability of the plant being destroyed in its native habitat. The great value of the drug in dysentery, and its rapid increase in price from an average of 2s. 9-Jd. per lb in 1850 to about 8s. 9d. per lb in 1870, led to attempts to acclimatize the plant in India, which, however, have not hitherto proved to be a commercial success, owing to the difficulty of finding suitable spots for its cultivation, and to its slowness of growth. Like other dimorphic plants, ipecacuanha ripens seeds best when cross-fertilized, and presents various forms. Two of these have been described by Professor Balfour of Edinburgh, one distinguished by having a woody stem, firm elliptic or oval leaves, with wavy margins and few hairs, and the other by an herbaceous stem, and leaves less coriaceous in texture, more hairy, and not wavy at the margins. This diversity of form is most apparent in young plants, and tends to dis-appear with age.
Ipecacuanha root occurs in pieces about 2 or 3 lines in thickness, of a greyish-brown or reddish-brown tint externally, having a ringed or annulated surface, and ex-hibiting a white or greyish interior and a hard wiry centre. It has a faint rather musty odour, and a bitterish taste. It is usually mixed with more or less of the slender subter-ranean stem, which has a very thin bark, and is thus easily distinguished from the root. The activity of the drug resides chiefly in the cortical portion, and hence the presence of the stem diminishes its value. The variety imported from New Granada and known as Car-tagena ipecacuanha differs only in its larger size and in being less conspicuously annulated. Ipecacuanha owes its properties to the presence of rather less than 1 per cent, of the alkaloid emetine, which, with the exception of traces, occurs only in the cortical portion of the root. The formula assigned to emetine has been variously stated by different chemists, that published by Lefort and Wurtz in 1877 is C28H40N2O5. Emetine is a white powder, turning brown on exposure to light, and softening at 70° C. (158° Fahr.). It is precipitated from its solution by tannin and nitrate of potassium, and is soluble in chloroform, but only slightly so in ether. A solution containing only -j-oVrj part of emetine has been shown by Power to become of an intense and permanent yellow colour when treated with a solution of chlorinated lime and a little acetic acid. Emetine exists in the root in combination with ipecacuanhic acid, which according to Reich is a glucoside. It is amorphous, bitter, and very hygroscopic. The root contains also about 37 per cent, of starch, a large quantity of pectin, and small proportions of resin, fat, albumen, and ferment-able and crystallizable sugar.
Ipecacuanha is one of the safest and most valuable emetics, being more suitable for administering to children than any other. The amount required to produce its effect varies considerably, children as a rule being more tolerant than adults : according to Ringer, thirty grains is the average dose for an adult, twenty grains for young children. Its action is rather slow, taking place in from 20 minutes to half an hour after ingestion. Minute quantities of the drug, on the contrary, such as drop doses of ipecacuanha wine every hour or three times a day, according to the urgency of the case, have the effect of checking vomiting arising from natural causes. The nauseating and emetic properties of ipecacuanha are believed to be due to its influencing the peripheral ter-minations of the pneumogastric nerve, since it produces vomiting even if injected into the blood. In nauseating doses it acts both as a diaphoretic and antispasmodic. It is also a stimulant or irritant of the mucous membranes, and is hence classed as an expectorant, and used success-fully in cough, bronchitis, gastric catarrh, and diarrhoea. Some individuals are so sensitive to the action of ipecacuanha as to suffer, even on smelling the drug on entering a room where it is kept, all the symptoms of coryza, hay fever, or bronchitis. In large doses of from 60 to 90 grains, repeated if required in 10 or 12 hours, the patient lying on his back to prevent sickness or nausea, it is found to be one of the most valuable remedies in dysentery, especially in the epidemic and sporadic forms met with in tropical and malarious countries. Externally applied in the form of ointment, ipecacuanha causes con-siderable irritation, followed by the appearance of pustules and ulceration. In doses of one-eighth to one-sixth of a grain it acts as a stomachic, and probably increases the gastric secretions.
Other plants to which the name of ipecacuanha has been popularly applied are American Ipecacuanha (Gillenia stipulacea, Spreng.), Wild Ipecacuanha (Euphorbia Ipecacuanha, L.), Bastard Ipe-cacuanha (Aselepias eurassavica, L.), Guiana Ipecacuanha (Boer-havia decttmbens, Vahl), Venezuela Ipecacuanha (Sareostemma glaueum, H. B.), and Ipecacuanha des Allemands (Vincetoxieum officinale, Moench.). All these possess emetic properties to a greater or less degree.
The term poaya is applied in Brazil to emetic roots of several genera belonging to the natural orders Cinchonacem, Violacese, and Polygalaceee, and hence several different roots have from time to time been sent over to England as ipecacuanha ; but none of them possesses the ringed or annulated appearance of the true drug. Of these the roots of lonidium Ipecacuanha, Vent., Bichardsonia scabra, St. Hih, and Psychotria emetica, Mutis, are those which have most frequently been exported from Brazil or New Granada.
See Pharmacographia, 2d ed., pp. 370-376 ; Bentley and Trimen, Medicinal Plants, 20 ; Martius, Systema Materiae Medicae Brasiliensis, p. 91-94 ; Ringer, Handbook of Therapeutics, 8th ed., p. 406; Bartholow, Materia Medica and Therapeutics, pp. 423-428. (E. M. H.)