Working bulletin for the scientific investigation of Cascara sagrada (Rhamnus purshianus) / issued in pursuance of a system of collective investigation of new drugs established and conducted by the Scientific Department of Parke, Davis & Co. ; analytical chemistry under charge of A.B. Lyons, pharmacology under charge of F.E. Stewart, botany H.H. Rusby.

Parke-Davis

Date:: 1885

Credit: Working bulletin for the scientific investigation of Cascara sagrada (Rhamnus purshianus) / issued in pursuance of a system of collective investigation of new drugs established and conducted by the Scientific Department of Parke, Davis & Co. ; analytical chemistry under charge of A.B. Lyons, pharmacology under charge of F.E. Stewart, botany H.H. Rusby. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

19/42 page 17

when I have had further experience, and will then give my opinion as to Us utihty If cascara sagrada will but approach the expectations of those who have thus far tried it and what if claimed for it. it will at no distant day become one of the standard Drenaratrons Ind a favorite with the profession-for the number of individuals who are tSled with constipation is very large, and apparently on the increase-as a result of ^'irhlVtre^dramfgroTS^^^^^^ pleasant to take, and the dose required is but small, which is strongly in its favor. Report 15 *—Since the history of man this morbid condition (constipation; has annoved and discomforted innumerable individuals, while in a great many it has become the source of great mischief, and in not an inconsiderable number it has actually been the cause of death. , u v. a The subjects of constipation have been, and still are, the subjects of much bad treatment either at their own hands or at those of quacks, and sometimes of even regular practitioners. Usually, the sufferer first tries home remedies after which, in this country, he goes to the drug store, and either subjects himself to the advice of an ignorant druggist, or buys a patent medicine. These means failing, he consults a phy- sician, and here, in too many instances, he is turned off in a few moments with a favorite prescription. Generally all the physician imiuires after is how long the patient has been constipated, and how often he or she has an alvine evacuation. The question of making a correct physiological, pathogenic or pathological diagnosis is entirely ignored. When one remedy fails another is tried until the whole therapeutical implements of attack are gone through with. While infrequent evacuation, or constipation, is very prevalent, all who are thus affected should not be considered in a pathological condition. There are, doubtless, many individuals who have alvine evacuations only once in two, three, four, or even more days, and yet are in the realms of a physiological condition. Two individuals may have the same number of passages, and one be constipated while the other is not. Hence it will be seen that care should be used before prescribing to see whether we have to do with a normal or abnormal condition, and this is not always the easiest thing in the world to de- termine. It is often difficult to say where the physiological process ends and the patho- logical begins. This much may be said, however, that physiologically inactive bowels are much more prone to take on pathological action than where there is no such torpidity. Now, it should be remembered that what may be designated pathological const! pation is not a disease in and of itself, but only a functional derangement of the alimentary canal. The causes and diseases on which this derangement depends are very various. The quantity and variety of food, the process of digestion, the quantity and quality of the secretions which are poured into the alimentary canal, muscular contractility of the intes- tines, abdominal walls and diaphragm, nervous enervation, quality and quantity of the blood, condition of sphincter ani, habit, etc.—these, with all general and organic troubles that may influence the proper and timely expulsion of the alimentary refuse, should be brought into view before prescribing. The conditions I wish more particularly to call attention to in this article are muscular sluggishness of the intestines, and an improper and insufficient supply of secre- tions. It is well known that, in order to effect the timely expulsion of the refuse material in the intestines we must have sufficient muscular contractility, and that the faecal mass must possess a certain amount of moisture on its surface, or the intestine must itself be bathed with a moisture or secretion in order that the mass will glide along easily. If either one of these conditions fail the faecal mass will certainly have great dif- ficulty in making its passage, and its progress will finally be arrested in the large intestines. The bad effect of this arrest on the general system is well known to all medical men of any experience. The digestion must become impaired, and so with assimilation. The noxious materials, absorbed from the faecal mass materially and seriously affect the whole nutritive process and produce innumerable abnormal nervous phenomena. Before giving my experience with cascara sagrada, I wish to relate two cases of obstinate constipation, as showing what serious trouble may be produced, and how easily the difficulty was overcome by what I consider rational treatment, after every effort for several weeks previous had failed. Case I. Mrs. X., at. 34, nervous temperament, was confined of her fourth

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