CHRYSOPHANIC ACID.
C14H10O4.
An organic acid obtained from Rhubarb and some lichens (Parmelia,
Squamaria, etc.).
Authority.
J. Ashburton Thompson, M.D., Brit. Med. Journ.,
1877 (1), p. 607.Deductions from 319 observations; 206 of these were on persons who were
out of sorts rather than ill.The crude powder and the extracted acid have the same locally irritant
effects; either kept in contact with the skin produces irritation, inflammation, and
discoloration of the cutis. Either introduced in minute quantity to the eye causes
conjunctivitis.On reaching a dose of 6 grains, I experienced sensations of nausea,
accompanied and followed by sensations of disturbance in the bowels; even an abortive
attempt at vomiting; then relief from all symptoms (after four hours). Sensations of
disturbance in the bowels, accompanied and followed the sensations of nausea (after four
hours). A loose action of the bowels (after twenty hours).My brother dined at 7; at 8.30 he took 8 grains of C. made into a pill
with confection of roses.Vomited (after two hours); aroused from sleep by another attack of
vomiting (after three hours and a half). No depression, except during the act of vomiting.
Second series of observations, including 90 cases, 30 children and 60
adults: Vomiting is always the first sign of action; this is not attended by any
depression at all comparable with that caused by tartar emetic or ipecacuanha; in children,
as well as in adults, the acts of vomiting varied between none in three out of the whole
number and six in two out of the whole number; they were usually two or three; very often
only one; the nausea continues more or less markedly until the bowels recover.The action on the bowels is variable, from none in a few cases to nine or
ten in equally few cases; most often the range was between three and seven; there is no
griping pain; the motions are very watery, and of such a brown color as suggests its origin
with the powder taken; if the vomiting be very early, then the purgation, although marked by
a fluid stool or stools, will certainly not be violent; and in some cases, in which there
was no vomiting, the bowels acted very freely; it does not always happen so, however, under
the same condition; and I conclude, therefore, that some persons can take a larger dose than
others.A dose of six grains produces scarcely any effect upon children of
twelve, eleven, ten, or nine years; upon children of eight and six years, the effect is
uncertain; upon children of from five years down to five weeks, it is certain to operate;
but the time which elapses before its action is manifested may vary between ten minutes and
nine, even, twelve, hours; the effect of the same quantity is not increased as the age of
the child is diminished. (Thus, three children of five weeks, of three years, and of six
years, respectively, were affected by the six-grain dose to the same degree). I am not able
to say upon what this peculiarity depends, but the intervention of sleep delays the
manifestation of any effect, and was the cause of delay
in the two cases in which alone so long intervals as nine and twelve hours elapsed. A
scruple is a moderate dose for an adult; the interval which elapses before it begins to
operate may be so long as five hours; but, if the dose be well adapted to the individual,
that is quite exceptional; four hours is a pretty frequent interval, but two hours or less
is the most common interval; it may be so short as fifteen minutes, but is seldom shorter
than thirty. I conclude that Chrysarobin is, in a dose of twenty-five grains for adults or
of six or more grains for children, an emetic purge, of which the action is unattended by
any inconvenient symptoms.
Observations of Chrysophanic acid upon 116 persons, of all ages, and both
sexes: The action of Chrysophanic acid is similar to the action of Chrysarobin,
with this difference, that while in a suitable dose each will cause vomiting and purging, if
the dose be too small Chrysarobin is most likely to purge alone, while Chrysophanic acid is
most likely to cause vomiting only. A larger full dose, that is to say, from fifteen to
twenty grains, will always both vomit and purge the patient very freely, at the same time
that it causes an inconvenient amount of either of those effects very rarely indeed.
Farther, there is but little danger of inconvenience from too large a dose.
The dose of Chrysophanic acid
. In this case, as in that of
Chrysarobin, I observe first of all, with a quantity which acts well upon a child of five or
six years of age, no increase in effect is observed with the same dose upon the very
youngest children; yet farther, of Chrysophanic acid I am obliged to say what does not hold
good of Chrysarobin, that on children of less than four or five years its action is
uncertain, in that it sometimes fails to act entirely, or acts very feebly, or most often of
all causes vomiting only; it never acts upon them with unexpected violence. I have found
that six grains of Chrysophanic acid is a good dose for children of ten years and under. For
adults, I find the action of the acid certain in a dose of fifteen grains; upon some adults
I have found ten and even eight grains act as often as fifteen grains upon other adults
apparently of similar physique; and again I have found some, but very few, who demand as
much as a scruple for the manifestation of a reasonably brisk action.Of Chrysophanic acid I have observed this effect: whatever the condition
of the patient, it causes the evacuation, one way or the other, of large quantities of bile.
Fourth series of observations
: I made ten observations on
adults with the resin of Chrysarobin, made into pills with Tragacanth and Glycerin. One
grain had no effect upon two individuals; in three cases three-grain doses caused vomiting
from twice to five times, and purging from five to seven times; in one case, two grains were
taken by a man, aged twenty years, instead of four as was intended; in six hours, the bowels
began to act, and then they acted very loosely three or four times; there was no vomiting,
but considerable nausea, which lasted for eighteen hours; in the remaining four cases, four
grains were taken for a dose; and this in every case acted within two hours, in one within
half an hour, vomiting being the first sign, and purging very quickly ensuing; in three of
these cases the acts of vomiting were three to five; of purging from five to ten; in the
fourth, a stout woman, fairly strong, and the subject of habitual constipation, the vomiting
and purging were continued during five or six hours, with very small intervals; she was
suffering from neuralgia, which I had traced to the state of the bowels, and it disappeared
during this violent action; the sickness, except in the last case, was not said to be
attended with much depression. It will thus be seen that the resin of Chrysarobin is
identical with that of the crude powder and of Chrysophanic acid, but very much more
powerful.If a dose of Chrysophanic acid be taken, and immediately followed by a
meal, its action will be considerably delayed; if it be taken after a meal, its action will
be delayed in proportion (more or less) to the progress which has been made with digestion;
if it be taken upon an empty stomach, its action is manifested quickly; there seems reason
to believe that fulness of the stomach, or the consequent delay in action, determines its
effects to the bowels, without in all cases obviously diminishing its emetic power; but
emptiness of the stomach does determine it rather to emetic action, and does also diminish
its purgative action, notwithstanding that, except in the case of babies, the latter is
never entirely absent.From these 319 cases I conclude that Chrysophanic acid is an emetic
purge; its action is as certain, when given in appropriate dose, as that of any other drug
which acts in either of these ways; if either kind of action should be wanting, on account
of the dose having been too small, it is the purging which will fail to appear; but that is
rare.® 2000
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