(May Apple.)

Origin. - The dried rhizome and roots of Podophyllum peltatum L., an herbaceous perennial growing in rich woodlands in Canada and the United States.

Description and Properties. - Of horizontal growth, consisting of joints about 2 inches (5 Cm.) long, flattish cylindrical, about 1/4 inch (6 Mm.) thick, but somewhat enlarged at the end, which has a circular scar on the upper side, a tuft of about ten nearly simple, fragile roots on the lower side, and is sometimes branched laterally; smooth or somewhat wrinkled, orange-brown, internally white and mealy, with a circle of small wood-bundles; pith large; nearly inodorous; taste sweetish; somewhat bitter and acrid.

Podophyllum contains a resin, podophyllin, composed principally of two anhydrous isomeric, glycosides podophyllotoxin and picropodophyilin. These represent the active principles, although attempts have been made to show that picropodophyilin is included in the composition of the former glycoside. Among other constituents of the drug are several minor resins and a coloring principle.

Dose. - 5-20 grains (0.32-I.29 Gm.) [7 1/2 grains (0.5 Gm.), U. S. P.].

Official Preparations

Fluidextractum Podophylli - Fluidextracti Podophylli - Fluidextract of Podophyllum.Dose, 5-20 minims (0.32-1.29 Cc.) [8 minims (0.5 Cc), U. S. P.].

Resina Podophylli - Resinae Podophylli - Resin of Podophyllum. - Description and Properties. - An amorphous powder, varying in color from grayish-white to pale greenish-yellow or yellowish-green, turning darker when exposed to heat; having a slight peculiar odor and a peculiar, faintly bitter taste; permanent in the air; soluble in alcohol in all proportions.

Dose. - 1/8-1 grain (0.008-0.06 Gm.) [1/10-1/4 (0.005-0.015 Gm.), U. S. P.].

Pilulae Podophylli, Belladonnae et Capsici - Pilulas Podophylli, Bellad6nnae et Capsici - Pills of Podophyllum, Belladonna and Capsicum. - Each pill contains 1/4 grain (0.016. Gm. = 16 milligrammes) resin of podophyllum, 1/8 grain (0.008 Gm. = 8 milligrammes) extract of belladonna leaves, and 1/2 grain (0.032 Gm. = 30 milligrammes) capsicum.

Dose. - Average dose: 1 pill (U. S. P.).

Physiological Action and Therapeutics. - The powdered root is an irritant to the skin, and when inhaled occasions a decided irritation of the eyes and respiratory passages. It is absorbed when applied to ulcers and raw surfaces, producing its characteristic purgative effects. The drug is a gastro-intestinal irritant, being apt to excite nausea, in full doses producing salivation and greatly augmenting the intestinal secretions, and especially the bile. Under full doses of podophyllum there is marked peristalsis, attended with severe griping pains, and in the course of ten or twelve hours there is produced a complete evacuation of the bowels, the feces being liquid and deeply stained with bile.

The drug is thought to be an active hepatic stimulant and cholagogue, it is a peculiarly appropriate remedy in that condition known as torpor of the liver. The constipation attending hepatic cirrhosis and cancer, as well as that from any hepatic disorder, is well treated by podophyllum.

The slowness and completeness of its action, together with its property of stimulating the functional activity of the liver, renders the drug extremely serviceable in the treatment of habitual constipation from any cause.

It should, however, be associated with antispasmodics, such as hyoscyamus or belladonna, to overcome its griping. When associated with other purgatives care should be exercised to select those only which, like itself, are tardy in their action.

Owing to the susceptibility of certain persons to the drug, the dosage should be small at first and gradually increased as necessary.