Podophyllum. Podophyllum peltatum.

Synonym—Mandrake.

CONSTITUENTS—

Picropodophyllin, picropodophyllic acid, podophylloquercetin, gum, starch, gallic acid, volatile oil, fixed oil, salts.

PREPARATIONS—

Extractum Podophylli Fluidum, Fluid Extract of Podophyllum. Dose, from five to ten grains.

Resina Podophylli, Resin of Podophyllum, Podophyllin. Dose, one-eighth grain.

Specific Medicine Podophyllum. Dose, from one-fourth to ten minims.

This exclusively Eclectic remedy has occupied a prominent place in our literature for eighty-five years. John King isolated Podophyllin as a resinoid in 1833, and published a report of his method and observations on the remedy in 1844 in the Philosophical Medical Journal of New York. Following King's suggestions, Lewis made an analysis of the drug in 1847 which was first quoted by the U. S. Dispensatory in 1854, twenty-one years after King had first isolated the resinoid. It was called by the Eclectics of that time vegetable calomel because it was used to replace calomel in their therapeutics.

In malarial country regions this agent will be more often indicated than in the city, as the habits and environment of city life are more apt to induce extremely opposite conditions to those which indicate Podophyllin.

Administration—The physiological action does not suggest to a great degree the uses which our experience has taught us to make of this remedy. The drastic cathartic influence we do not need, as it is too harsh in its active influence. From five to thirty drops of the tincture in a four ounce mixture, or from one two hundredths to the one-twentieth grain of Podophyllin, will be found sufficiently active.

Specific Symptomatology—This agent is demanded in inactive, conditions of the gastro-intestinal tract, indicated by a heavily coated tongue, which is thick, broad and pale, and the coat of dirty yellow color especially at the base, together with perhaps vertigo, complete anorexia, and dull, heavy headache. The circulation is full and sluggish, and the abdominal viscera is in a plethoric condition.

Therapy—These conditions will suggest the use of the agent whatever the name of the existing disease. In acute inflammatory conditions, or in irritable conditions of the stomach or bowels, it is contra-indicated in active doses.

In the condition known as biliousness, with markedly inactive liver, sallow skin and conjunctiva, constipation, highly colored urine containing uric acid, urates in great excess, and bile, it is of value. In these cases the following formula, although unpleasant to the taste, will be of great service:

Tincture of podophyllum, tincture of leptandra, of each half a dram; tincture of capsicum twenty minims; syrup of liquorice. half an ounce; port wine sufficient to make four ounces. Give a teaspoonful every two or three hours.

If there is enlargement of the liver, with general indisposition, soreness over the liver and pain through the right side and under the right scapula, it is the remedy.

In inactivity of the liver characterized by constipation, the feces when passed being solid or hard and of a grayish or clay color, and floating upon water, with general indisposition, podophyllin may be given in doses of one-fiftieth of a grain every two or three hours. If there is a great sluggishness with obstinate constipation, one-tenth of a grain may be given for two or three doses, the smaller doses to follow. It is given in jaundice with its marked indications to excellent advantage. If given for its cathartic influence it should be combined with hyoscyamus or belladonna, or it may be given in conjunction with leptandra virginica.

Podophyllin, in from one-half to one grain doses repeated once or twice, and followed by half a pint of pure olive oil, is reasonably sure treatment in the removal of gall stones. The results may be painful, but the patient will have subsequent relief.

The agent in minute doses will permanently cure some conditions which cause chronic constipation, but if desired for this purpose, like cascara, it must at no time be given in full active doses. Locke advises a teaspoonful of a mixture of thirty grains of the second decimal trituration in a half glass of water to be given a child three times each day for constipation.

In minute doses it will stimulate intestinal secretion and peristaltic action in children, and overcome dry stools, and constipation and bloated bowels, with erratic colicky pains.

In the treatment of hemorrhoids accompanied with constipation from deficient peristalsis and general abdominal plethora, podophyllum is of direct service. It can be given in conjunction with collinsonia and the effects are marked from the first.

The writer has prescribed the tincture or fluid extract of podophyllum for several years as an alterative. If the plethoric conditions named as indicating it are present, it is much more active, and is always to be given in doses sufficiently small to avoid any irritating or cathartic effects. In skin diseases of childhood, such as cracked and fissured conditions of the skin of the face, or eczema, or persistent pustular conditions, it is of value.

It may be prescribed with most happy results with other alteratives in scrofula or syphilis, or in the eruptions which result from these disorders.

Younkin is authority for the use of this agent in one-sixth of a grain doses, with ten grains of the potassium bitartrate, given every two hours in gonorrheal epididymitis, of which it relieves the pains and abridges the inflammation. Other indicated remedies are, however, not to be overlooked. It may be given with confidence in this condition.

The American Materia Medica, Therapeutics and Pharmacognosy, 1919, was written by Finley Ellingwood, M.D.
It was scanned by Michael Moore for the Southwest School of Botanical Medicine.