154 
CEPHAELIS IPECACUANHA. 
nausea and vomiting; in smaller doses its effects are expecto- 
rant and diaphoretic, and in very small quantities it gently sti- 
mulates the stomach, and gives energy to the digestive organs, 
increasing the appetite and promoting digestion. Dr. A. T. Thom- 
son justly observes, " as an emetic it is mild, safe, and certain in its 
operation ; but it is a mistake, that when given in larger doses than 
are necessary, it does not operate more violently, but only in a 
shorter space of time. It does not act so quickly as many other 
emetic substances ; but it evacuates completely the contents of the 
stomach, and does not so much weaken it as antimonial emetics." 
Its secondary effects seem to depend upon the sympathy of other 
parts with the stomach, and in this way we presume it acts as a 
diaphoretic, expectorant and antispasmodic, and also in checking 
haemorrhages. Ipecacuanha is given in a great variety of diseases, 
and when properly administered generally proves serviceable ; at the 
commencement of intermittent and continued fevers, when given in an 
emetic dose it frequently cuts short the disease. At the commence- 
ment of many inflammatory diseases, when the inflammation does 
not run very high, its effects are to cut short the disease ; hence it 
is given in inflammation of the pharynx, larynx and trachea, also in 
rheumatism, bubo, swelled testicle, cynanche tonsillaris, purulent 
ophthalmy, abscess, and in every case where we wish to evacuate the 
stomach. Its good effects, when exhibited in small doses, in dysen- 
tery and chronic diarrhoea are so decided, that formerly it was 
esteemed a specific in those diseases; the good effects, however, 
seem to depend upon its producing a steady determination of the 
peristaltic motion of the intestines downwards, and also by the 
nausea which is kept up, diminishing the arterial excitement and 
determining to the surface. In this way also, (by lessening the force 
of the circulation) its beneficial effects in uterine ^nd pulmonary 
haemorrhages may be accounted for. The sudorific effects of 
ipecacuan are considerably increased by its combination with opium, 
and in this way it is exhibited in almost every case in which we wish 
to promote perspiration, particularly in acute rheumatism, dropsy, 
and arthritic affections. It is given in exanthematous diseases when 
the eruption is disposed to recede, and in many other cutaneous 
diseases. In very small doses its expectorant powers have been 
found exceedingly useful in the early stage of phthisis, catarrhal 
affections, and in pneumonia after the free use of the lancet. 
Ipecacuan is exhibited in substance, ot infused in wine or water. To 
excite vomiting, the dose of this powder is from 15 to 30 grains ; 
the vinous infusion is given in doses of from one to two ounces. 
