Origin. - The bulb of Urginea tnaritima (L.) Baker, a plant indigenous in the basin of the Mediterranean, from Syria westward to the coast of the Atlantic. The bulb is deprived of its dry, membranaceous outer scales and cut into thin slices, the central portions being rejected.

Description and Properties. - Occurring in narrow segments about 2 inches (5 Cm.) long, slightly translucent, yellowish-white or reddish, brittle and pulverizable when dry, tough and flexible after exposure to damp air; inodorous; taste mucilaginous, bitter, and acrid. Merck isolated three active glycosides - scillipicrin, scillitoxin (both acting upon the heart), and scillin (an emetic principle) - together with various unimportant substances, such as mucilage, sugar, etc. Jamerstedt's scillain has been held to be identical with Merck's scillitoxin.

Dose. - 1-4 grains (0.06-0.25 Gm.) [2 grains (0.125 Gm.), U. S. P.].

Official Preparations

Acetum Scillae - Aceti Scillae - Vinegar of Squill (10 per cent.). - Dose, 10-30 minims (0.6-2.0 Cc.) [15 minims (1 Cc), U. S. P.].

Fluidextractum Scillae - Fluidextracti Scillae - Fluidextract of Squill. - Dose, 1-4 minims (0.065-0.25 Cc.) [1 1/2 minims (0.1 Cc), U. S. P.].

Syrupus Scillae - Syrupi Scillae - Syrup of Squill (45 per cent. of the Acetum). - Dose, 30-60 minims (2.0-4.0 Cc.) [30 minims (2 Cc.), U. S. P.].

Syrupus Scillae Compositus - Syrupi Scillae Compositi - Compound Syrup of Squill. - Fluidextract 8 per cent., with fluidextract of senega 8 per cent., and tartar emetic 0.2 per cent., or 1/8 grain (0.008 Gm.) to 1 fluidram (4.0 Cc). - Dose, 15 minims to 2 fluidrams (1.0-8.0 Cc) [30 minims (2 Cc), U. S. P.].

Tinctura Scillae - Tincturae Scillae - Tincture of Squill (10 per cent.). - Dose, 5-20 minims (0.3-1.3 Cc.) [15 minims (1 Cc), U. S. P.].

Antagonists and Incompatibles. - The action of squill upon the circulatory system is antagonized by the cardiac depressants. Tannic acid is incompatible.

Synergists. - The diuretic action of squill is enhanced by the diuretics and many of the cardiac stimulants. As an expectorant the drug is aided by senega and tartar emetic.

Physiological Action. - Externally and Locally. - There is no action of special importance. Applied to mucous membranes, however, squill acts as an irritant.

Internally. - Digestive System. - Large doses of the drug excite nausea, vomiting, and purging. Excessive amounts may produce gastro-enteritis.

Circulatory System. - The action of squill upon the heart and blood-vessels resembles that of digitalis, although as a cardiac stimulant digitalis is the more powerful.

Nervous System. - Squills has little action on the nervous system in medicinal doses.

Respiratory System. - The bronchial mucus is increased and expectoration facilitated by small doses of squill. Toxic doses render the respiration rapid and shallow.

Absorption and Elimination. - The active principles of squill are quickly diffused through the blood, being eliminated chiefly by the kidneys and bronchial mucous membrane.

In the passage of squill through the kidneys the renal epithelium is stimulated by the drug, which influence, together with the drug's action upon the systemic circulation, renders squill an active and valuable diuretic, increasing not only the amount of urine, but also the quantity of inorganic solids.

Very large doses irritate and inflame the kidneys, resulting in strangury and hematuria, with occasionally entire suppression of urinary flow.

Untoward Action. - This does not differ essentially from the symptoms of "Poisoning."

Poisoning. - In toxic doses squill acts as an acrid narcotic poison. The symptoms produced by excessive doses are - nausea, violent vomiting, serous and bloody diarrhea, severe griping, a sensation of burning in the throat, vesical tenesmus accompanied by pain, bloody urine, and, perhaps, entire suppression of the urinary flow. The pulse is feeble and slow or sometimes rapid, the symptoms terminating in collapse and death, occasionally preceded by convulsions. The death of a child three to five years of age has occurred from the taking of a half-teaspoonful of the syrup of squill.

Treatment of Poisoning. - The stomach should be evacuated and demulcent drinks freely given. Opium may be necessary to relieve pain, while diffusible stimulants serve to counteract cardiac and respiratory depression. Otherwise as in digitalis poisoning.

Therapeutics. - Squill is not used externally and locally. It has been employed internally as a diuretic in dropsy. When associated with digitalis and calomel it is an exceedingly active diuretic in cases of cardiac dropsy, chronic pleurisy, and pericarditis with effusion.

Squill is an efficient expectorant, the vinegar, syrup, and compound syrup of squill being useful preparations in subacute and chronic forms of bronchitis, particularly when the sputum is tenacious and expelled with difficulty.

Contraindications. - Squill should not be employed in cases of acute diseases of the kidneys. It is also inadmissible in acute bronchitis and in phthisis.

Administration. - Any of the preparations of the drug may be given, to be prescribed well diluted with syrup or glycerin.

Inasmuch as the diuretic action of squill ceases after a while, the doses should be repeated and gradually enlarged until some untoward action intervenes, when further increase should be suspended.

Because of its too-irritating properties the drug is seldom given alone when desired for its diuretic action.

Owing to the free acetic acid which it contains, syrup of squill is incompatible with ammonium carbonate and other alkalies.