i8o MATER i A MEDIC A AND THERAPEUTICS. 



ACTION AND USES. 



Calumba is the first of the large and important group of 

 hitter suhstances or bitters, which we meet with in the 

 materia medica, and will therefore he fully discussed as the 

 type of this class of remedies. Under the head of the other 

 bitters, such as quassia and gentian, fresh description of their 

 action and uses will be unnecessary, and reference will simply 

 be made to the present account. So with the action and uses, 

 as litters, of the alkaloids (strychnia, quinia, etc.), and the 

 aromatic bitters, including orange, lemon, cascarilla, etc. 



1. IMMEDIATE LOCAL ACTION AND USES. 



Externally. Calumba and other bitters are antiseptic and 

 disinfectant to a degree, arresting decomposition and fermenta- 

 tion. They are not used for this purpose. 



Internally. Taken into the mouth, bitters, as their name 

 implies, stimulate the nerves of taste, and thus induce several 

 general reflex effects, of the first importance in digestion. (1) 

 The saliva is increased, and therewith its solvent and digestive 

 influence on the food in the mouth, as well as its stimulant 

 action on the gastric secretion ; (2) The vessels and g lands of the 

 stomach are excited through the central nervous system, and 

 the gastric secretion is thus increased in a second way ; an 

 effect which is heightened if the bitter be aromatic, and relish 

 given by the pleasant flavour. 



Reaching the stomach, calumba and other bitters stimulate 



digestion in a third way, by acting upon the gastric nerves and 



causing a sensation closely resembling hunger. This rouses 



the appetite, and if food be taken within a few minutes, the 



other effects just described afford the means of digesting it. 



As in the mouth, the action of bitters in the stomach is greatly 



I by aroma tics (essential oils) and alcohol (contained in 



linctmv.s). Jake these substances, bitters also stimulate tbe 



local circulation, and produce a remote effect on the heart and 



systemic vessels, raising the blood pressure, and thus acting as 



nil tonics." They will also exert a certain controlling 



cflcct on any decomposition or fermentation which may be set 



up in the stomach. When given in excess, or for a long time, 



will manifestly, for every reason, tend to irritate the 



stomach and induce indigestion. 



Calumlu and bitters in general pass slowly along the 

 intestines, moderating decomposition, and slightly stimulating 

 I sis when they contain tannin, which many of them do. 

 'J h y arc not cholagogue. 



