Sanguinaria

Blood-root

Blood-root. The rhizoma of Sanguinaria Canadensis Linné (Nat. Ord. Papaveraceae), collected in autumn. (U. S. P.)

Tinctura Sanguinariae

Tincture of sanguinaria. Dose, τη v— 3ss.

Acetum Sanguinariae

Vinegar of sanguinaria (sanguinaria, 10 parts; diluted acetic acid, sufficient to make 100 parts). Dose, τη v— 3 ss. (Not official.)

Extractum Sanguinariae Fluidum

Fluid extract of sanguinaria. Dose, τη ij—τη xx.

Composition

Sanguinaria contains an alkaloid, sanguinarine, which appears to be identical with the chelerythrine of Probst. Sanguinarine is a white, pearly substance of an acrid taste, very sparingly soluble in water, soluble in ether, and very soluble in alcohol. With the acids it forms salts soluble in water, all of which have some shade of red, crimson, or scarlet, and form beautiful red solutions. Another alkaloid, named porphyroxine (sanguinaria-porphyroxin—Husemann), has been found by Riegel. Besides these alkaloids, sanguinaria contains a peculiar acid, chelidonic, and another has been announced, for which the name sanguinarinic acid has been proposed, but this latter acid has been shown to be a mixture of malic and citric acids. The alkaloids exist in the root in combination with these acids—the most important compound being the chelidonate of sanguinarine. Besides the foregoing, blood-root contains the following unimportant constitU' ents: resin, gum, extractive, albumen, sugar, etc

Antagonists and Incompatibles

Alkalies, tannic and gallic acids, and most of the metallic salts, are chemically incompatible with the preparations of blood-root. The local irritant action of the drug and the depression of the circulation which it causes are antagonized by opium, by amyl nitrite, by atropine, etc.

Synergists

The mineral and vegetable emetics, the so-called alteratives of the vegetable kingdom, and the mineral salts, considered from the therapeutical point of view, promote the physiological and therapeutical effects of sanguinaria.

Physiological Effects

Sanguinaria has a bitter, acrid taste, which persists for a long time. When swallowed, it leaves a sense of constriction and acridity in the throat. It excites a feeling of heat in the stomach, and stimulates secretion of the mucous membrane. If the quantity taken is insufficient to produce nausea, the action of the heart is increased, and a subjective sensation of warmth is experienced throughout the system. In considerable doses sanguinaria is an active emetic, producing much nausea and depression, and slowing the action of the heart. It is very irritating to the mucous membrane. Snuffed up the nose, it produces violent sneezing. In large doses it inflames the stomach, producing intense burning, with thirst, great prostration, dimness of vision, vertigo, and collapse.

The alkaloid, sanguinarine, manifests all the physiological capabilities of the drug. It has an intensely bitter, acrid taste. In small doses (one twelfth to one eighth of a grain) it simply increases secretion of the gastro-intestinal mucous membrane; in doses of one sixth to one fourth of a grain it causes depressing nausea and sometimes vomiting. In large doses it produces, in addition to the gastric symptoms mentioned above, slowing and irregularity of the pulse, cold sweats, cold extremities, vertigo, dilated pupils, anxiety, etc.

Applied to fungous granulations, sanguinaria has considerable es-charotic power.

The sketch above given of the physiological actions of sanguinaria, which embodies the results of the author's investigations and clinical studies, requires no special modification. The recent elaborate and most thorough research of Dr. Robert Meade Smith confirms the author's account. The reader who wishes to exhaust the subject will find that nothing has been omitted by Dr. Smith.

Therapy

In atonic dyspepsia from two to five drops of the tincture, or the one twelfth of a grain of sanguinarine, may be used with advantage. It promotes secretion, and increases the appetite. There seems no doubt, according to the author's observation, that sanguinaria promotes the hepatic and intestinal secretions. It is, therefore, a serviceable remedy in duodenal catarrh, and secondary catarrh of the biliary ducts with jaundice.

Its most important therapeutical effects are witnessed in diseases of the respiratory organs. Chronic nasal catarrh is successfully treated by the internal use of the tincture (ten drops ter die), or of the alkaloid (one fifteenth of a grain ter die), and the local application of the powder, in small quantity, applied by an insufflator to the Schneiderian mucous membrane. In acute bronchitis (catarrh), after the subsidence of the more acute symptoms, it is a serviceable expectorant. It may be combined with other expectorants and alterants: Rx Tinct. sanguinariae, 3 j; tinct. lobeliae, 3 j; vini ipecac, 3 ij; syrup, tolutan., oz ss. M. Sig.: A teaspoonful every three hours as an expectorant. In humid asthma the following combination is extremely serviceable: Rx Tinct. sanguinariae, 3 j; tinct. lobeliae, 3 j; ammonii iodidi, 3 j; syrup, tolutan., 3 vj. M. Sig.: A teaspoonful every two, three, or four hours. In spasmodic asthma the same prescription is occasionally very effectual, but the author is unable to indicate the precise condition under which it is most useful.

Sanguinaria has been proposed as an emetic in croup. It is, however, too uncertain in action, and too harsh, to justify its use when there are so much more eligible remedies at hand.

The emmenagogue properties of sanguinaria seem well established. It is indicated when amenorrhoea is functional in character, when there is an absence of plethora, and when no malformation exists. It may be advantageously combined with aloes, provided there is no contraindication to the use of the latter. Rx Tinct. sanguinariae, 3 ij; tinct. aloes, oz ss;tinct. nucis vom., 3 ij. M. Sig.: Twenty drops two or three times a day, in amenorrhoea of anaimia, or chlorosis. Or the following: Rx Sanguinarinae, grs. ij; ext. aloes, grs. x; ferri redacti, Э j. M. Ft. pil. no. xx. Sig.: One pill three times a day.

Sanguinaria has decided aphrodisiac properties. When there are relaxation of the genital organs, diurnal losses, inaptitude (from irritability) for coitus, sanguinarine may be given as follows: Rx Ergotin (aq. ex.), Э j; sanguinarinae, grs. ij. M. Ft. pil. no. xx. Sig.: One, three times a day. As stillingia appears to have similar properties as an aphrodisiac, the following combination will prove useful: Rx Tinct. sanguinariae, 3 iij; ext. stillingiae fl., 3 v. M. Sig.: Fifteen to twenty drops, in water, three times a day.

As an alterant in chronic syphilitic and strumous affections, sanguinarine may be used in the same class of cases as sarsaparilla, guaiac, and stillingia. It is an important addition to a decoction of woods indigenous to our soil, used as a substitute for the more expensive and really less efficient foreign drugs of the same group.

Local Applications

Sanguinaria, having feeble escharotic property, is used as a local application to repress exuberant granulations, and to ill-conditioned ulcers to change their character. Several cases have been reported, indicating the power of sanguinaria to repress the growth and destroy nasal polypi.

A decoction of sanguinaria is a useful gargle in the sore-throat of scarlatina.

Authorities referred to:

Husemann, Drs. Aug. und Theo. Die Pflanzenstoffe, p. 199.

Porcher, Dr. Francis Peyre. Resources of the Southern Fields and Forests, p. 31, et seq.

Phillips, Dr. C. D. F. Materia Medica and Therapeutics, London, 1874, p. 143.

Stille, Dr. Alfred. Therapeutics and Materia Medica, fourth edition, vol. ii, p. 454.

Smith, Dr. Robert Meade. The Physiological Action of Sanguinarina. The Am Jour. Med. Sci., October, 1876, p. 346, et seq.