268 MATERIA MEDIC A AND THERAPEUTICS. 



5. Vimun Ipecacuanhse. 1 in 20 of Sherry. Dose, 5 to 40 min. 

 as an expectorant ; as an emetic, 3 to 6 dr. 



ACTION AND USES. 

 1. IMMEDIATE LOCAL ACTION AND USES. 



Externally. Ipecacuanha powder is irritant, and even 

 pustulant, but is never used to produce this effect. Exposed 

 mucous membranes are similarly affected by it. If taken as 

 snuff it causes irritation of the nerves, sneezing, and reflex 

 mucous secretion ; and the same effect follows its application in 

 smoke or spray to the pharynx, larynx, or lower air-passages ; 

 in some persons it excites asthma. In the form of a spray of 

 the diluted vinum, or inhaled as the smoke of the burning 

 powder, it is used to relieve cough due to dryness or deficient 

 secretion of the throat and air passages. 



Internally. Reaching the stomach, ipecacuanha in very 

 small doses (gr. |) is a gastric stimulant doubtless increasing 

 the local circulation and secretion. It is therefore a useful 

 addition to bitter stomachic and tonic mixtures, and will even 

 arrest vomiting due to certain obscure conditions of the gastric 

 nerves. The compound powder is of the greatest value in 

 ulceration of the stomach, and some forms of dyspeptic vomiting. 

 In larger doses (15 to 30 gr.) it acts as an emetic, partly by a 

 direct effect upon the stomach, and partly by exciting the 

 vomiting centre in the medulla (indirect emesis). This im- 

 portant subject will be discussed under the heading of the 

 specific action. 



In the intestines, ipecacuanha is still a stimulant, increasing 

 the flow of mucus ; and in large doses an irritant. A remark- 

 able tolerance of the drug is, however, readily established in 

 many persons suffering from dysentery, in which disease 

 ipecacuanha has the power of arresting the inflammatory action 

 in the bowel, checking the liquid and bloody evacuations, and 

 often effects a complete cure. For this purpose enormous doses 

 (30 to 90 gr.) are given, or large doses frequently repeated 

 (20 gr. every two hours). 



2. ACTION IN THE BLOOD. 



Emetin passes through the blood, from the alimentary canal 

 to the tissues, but is not positively known to affect it. 



3. SPECIFIC ACTION AND USES. 



Ipecacuanha (emetin) acts on the vomiting centre in the 

 medulla, i.e. is an indirect emetic, this effect being added to 



