IPECACUANHA  .2 The

root used in medicine under this name is obtained from Psychotria (or Uragoga) Ipecacuanha, a small shrubby plant of the natural order Rubiaceae . It is a native of Brazil, growing in clumps or patches in moist shady forests from 8° to 22° S., and is also found in New Granada and probably in Bolivia . 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 employed in Europe 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 moo louis d'or, and made public in 1688 . The botanical source of ipecacuanha was not accurately known until 1800 . The root appears to be possessed of very great vitality, for in 1869 MNab, 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 . %2d. per lb in 185o to about 8s . 9d. per lb in 187o, 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, anti presents various forms . Two of these were described by the late Professor F .

M .

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 disappear with age . 2 The name is the Portuguese form of the native word i-pe-kaaguene, which is said to mean " road-side sick-making plant " (Skeat, Etym . Dict . 1898) . 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 (see r in fig.), and exhibiting 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 subterranean 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 Colombia and known as Cartagena ipecacuanha differs only in its larger size and in being less conspicuously annulated . Ipecacuanha owes its properties to the presence of rather more than 1% of the alkaloid emetine, which, with the exception of traces, occurs only in the cortical Ipecacuanha Plant (about a nat. size) .

1, 2,

Flowers cut open, showing short-styled (I) and long-styled (2) forms; 3, Flower after removal of corolla, showing the inferior ovary (o), the small toothed calyx (c), and the style (s) with its forked stigma; 4, Ovary cut lengthwise showing the two chambers with the basally attached ovules; r, annulated root . portion of the root . It is a white amorphous substance, with the formula C20H30NO5 . It has a bitter taste, no odour, and turns yellow when exposed to air and light . There are also present a volatile oil, starch, gum, and a glucoside, which is a modification of tannin and is known as ipecacuanhic acid . The dose of the powdered root is 4 to 2 grains when an expectorant action is desired, and from 15 to 30 grains when it is given as an emetic, which is one of its most valuable functions . The Pharmacopoeias contain a very large number of preparations of this substance, most of which are standardized . A preparation from which the emetine has been removed, and known as " de-emetized ipecacuanha " is also in use for cases of dysentery . When applied to the skin, ipecacuanha powder acts as a powerful irritant, even to the extent of. causing pustulation . When inhaled it causes violent sneezing and a mild inflammation Other plants to which the name of ipecacuanha has been popularly applied are American ipecacuanha (Gillenia stipulacea), wild ipecacuanha (Euphorbia Ipecacuanha), bastard ipecacuanha (Asclepias curassavica), Guiana ipecacuanha (Boerhavia decumbens), Venezuela i(pecacuanha (Sarcostemma glaucum), and ipecacuanha des Allemands Vincetoxicum officinale) . 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 Rubiaceae, Violaceae and Polygalaceae, 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 Ionidium Ipecacuanha, Richardsonia scabra and Psychatria emetica are those which have most frequently been exported from Brazil or Colombia .