PAREIRA. 181 



The uses of calumba and other bitters internally depend 

 on the actions just described. They are of great value as 

 stomachics, and much employed in rousing gastric digestion in 

 atonic dyspepsia, where the appetite and the ability to digest 

 have been diminished or lost, as in anaemia, convalescence from 

 acute diseases, in persons exhausted by over- work, whether 

 mental or bodily, and in the subjects of chronic constitutional 



>, such as phthisis and syphilis. In such cases, bitter 

 infusions form the best vehicle for acid or alkaline stomachics, 

 as the case may require, combined with an aromatic tincture, 

 which renders the mixture much more agreeable and active. 

 Their use must not be continued too long without intermission ; 

 they must not be given in too concentrated a form ; and they 

 must be employed with caution, or entirely avoided, in cases 

 of dyspepsia attended by much pain, vomiting, mucous secre- 



- well as in organic disease of the stomach. Calumba 

 is one of the least irritant of all bitter stomachics. 



The action of bitters on the bowels no doubt adds to their 

 value in indigestion, as they remove flatulence and promote 



tion. Some forms of diarrhoea are relieved by calumba. 

 Whether given by the mouth or as enema, bitter infusions are 

 anthelmintic, preventing and destroying the thread-worm. 



2. ACTION ON THE BLOOD, SPECIFIC ACTION, AND REMOTE LOCAL 

 ACTION. 



Whether bitters possess any direct action on the blood 

 ues beyond those just described, is uncertain. The 

 indirect effect on the system is manifestly great and of the 

 first importance therapeutically, as they are the means of intro- 

 ducing into the blood an increased amount of nutrient mate- 

 rial. In this way bitters are tonics, invigorating the body 

 whilst they increase appetite ; a system of treatment which is 

 Me and striking to invalids and persons enfeebled by 

 , over-work, or dyspepsia. 



ParoiraR Radiv PAREIRA ROOT. The dried 

 root of Cissampelos Pareira. Brazil. T>o vx^^ 



>. Cylindrical oval or compressed pieces, entire 

 or split longitudinally, half an inch to four inches in diameter, 

 and four inches to four feet in length. Bark greyish-brown, 

 longitudinally wrinkled, crossed transversely by annular 

 elevations ; interior woody, yellowish-grey, porous, with well- 

 marked often incomplete concentric rings and medullary rays. 

 Taste at tirst sweetish and aromatic, afterwards intensely bitter. 



