Rheum. Rheum officinale.

Synonyms—Rhubarb, Chinese or Turkey Rhubarb.

CONSTITUENTS—

Chrysophan, phaeoretin, erythrorrhetin, aporetin, chrysophanic acid, rheotannic acid, emodin, gallic acid, rheumic acid, calcium oxalate, sugar, starch, salts.

PREPARATIONS—

Extractum Rhei, Extract of Rhubarb. Dose, from ten to fifteen grains.

Extractum Rhei Fluidum, Fluid Extract of Rhubarb. Dose, from a half to two drams.

Syrupus Rhei et Potassae Compositus, Compound Syrup of Rhubarb and Potassa, Neutralizing Cordial. Dose, from one to four drams.

Specific Medicine Rheum. Dose, from one to twenty minims.

Physiological Action—The influence of this agent is peculiar. It is a laxative first, cathartic if in extreme doses, and subsequently astringent. It tones the gastro-intestinal tract to a marked degree, if debilitated, and if over-activity is prevent, the agent restrains that condition.

It mildly and satisfactorily evacuates the bowels without irritation or stimulation. Some individuals eat a few grains of the crude root, which they carry in the pocket, every day for chronic constipation, others are not benefited with large doses.

Therapy—In atonic conditions of the bowels, with debility or general relaxation, whether diarrhoea, dysentery, cholera morbus or cholera infantum is present, it is a most useful remedy. Its tonic powers are promptly exercised, and properly combined with indicated remedies, it produces markedly restorative effects. It acts directly upon the duodenum, and subsequently upon the entire intestinal tract. It is the laxative for debilitated patients, or for patients recovering from prostrating disease.

Given to a nursing mother, like aloes, it relaxes the infant's bowels, and in some cases it is desirable to administer it to the mother for this purpose.

SYRUPUS RHEI ET POTASSAE COMPOSITUS.

Synonyms—Syrup of Rhubarb and Potassa Compound. Neutralizing Cordial.

This old Eclectic formula has attained such a wide notoriety—is in such general use in our own school, and is now so popular among the regular physicians and so generally adopted by them, that it deserves a conspicuous place in this book. It has no superior as a restorative to acute abnormal conditions of the stomach or bowels demanding an antacid. Prof. King's original formula is as follows, which happily combines the active virtues of its constituents. Suggestions and alterations for its improvement have not in all its factors produced a better compound.

Formula—

Best India Rhubarb, Golden Seal, Cinnamon, each one ounce;

Refined Sugar, four pounds;

Brandy, one gallon;

Oil of Peppermint, twenty minims.

Macerate the Rhubarb, Golden Seal and Cinnamon, in half a gallon of the Brandy for six hours, with a gentle heat, then transfer the mass to a percolator and displace with the remaining half-gallon of Brandy. The remaining strength, if there be any, can be obtained by adding water until the liquor comes off tasteless. To this add one ounce of Carbonate of Potassa, the Sugar and Oil of Peppermint, this last having been previously rubbed with enough Sugar to absorb it, and mix the two liquors. The whole of the active properties of the ingredients may be obtained with more certainty by using Alcohol, seventy-six per cent, instead of Brandy, owing to the great want of uniformity in the quality of the latter.

Because of the possibility of the fermentation of the sugar in the above compound, Professor Lloyd has replaced this and enough of the water necessary to the above solution, with glycerine, preserving the valuable properties of the compound and increasing the field of its action. This preparation is called Glyconda, and is given for the same conditions, and in the same dosage as the above.

Administration—The syrup is given in doses of from half a dram to half an ounce, usually diluted with considerable water.

Therapy—While we advocate the use of single remedies for direct effects, we have obtained such marked results from this combination that we are impelled to teach students its use, especially in children's gastric disorders. A sour stomach is always benefited by it. It is specific when the tongue is coated uniformly white, and is broad, and the mucous membranes are pale, when there are eructations of sour gas or vomitings of acid matter. It never fails in these cases. It makes no difference whether there is diarrhea or constipation.

A stomach filled with sour decomposed food can appropriate no medicine, and all specific remedies demand a stomach free from these conditions. This agent neutralizes excessive acidity without liberation of carbonic acid gas; it stimulates and soothes the stomach and promotes normal action. It may be given to neutralize excessive acidity before general medication is begun in any case.

It is the remedy for children's summer disorders par excellence. It is a safe remedy to use ad libitum in the family for deranged conditions of the stomach and bowels.

A tablespoonful, taken by an adult in summer when nausea, colic or diarrhea declare a derangement of the organs of digestion, will usually immediately restore the normal condition. It is palatable and pleasant to children, especially if diluted. In fevers or headaches from gastric acidity the treatment should be begun with this syrup, the indicated remedies being given when excessive gastric acidity is in part neutralized and the normal condition stimulated by the rhubarb. It may be added to the vehicle in prescriptions for stomach and bowel troubles of an atonic character.

If constipation be present a mild laxative may be added. If much diarrhea is present an astringent, such as geranium or epilobium will increase its value, and if there is extreme lack of tone, its value is enhanced by the tincture of xanthoxylum or capsicum. If there are sharp colicky pains, a few drops of the tincture of colocynth or the tincture of ginger, or even paregoric, or deodorized opium in severe cases, will be found valuable. It should be in constant use by every physician in stomach and intestinal disorders common during the heated term.

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.