Another disorder in which cimicifuga sometimes proves superior even to ar senic is chorea, when administered in full doses. Its action in this disease is due to its influence upon the reflex centres of the spinal cord.
Cimicifuga valuable in tinnitus auriuin. Conclusions:— 1. Buzzing of the ear may be considered as the reaction of the auditory nerve to direct or reflex irritation. 2. Cimicifuga raccmosa possesses an action upon the auricular circulation and upon the reflex irritability of the auditory nerve; the average active dose is 30 drops of the extract a. day. 3. Buzzing which has ex isted more than two years appears diffi cult to influence by cimicifuga. Albert Robin and Mendel (N. Y. Med. ,Tour., July 23, '93).
As already stated, it may be substi tuted for ergot in obstetrical practice when the latter drug cannot be obtained, but it is not as reliable. Its influence upon the uterine circulation and the in voluntary muscular fibre causes it to be very effective in cases of uterine con gestion whatever be the cause. It is, therefore, frequently employed in amen orrhcea, dysmenorrhcea, delayed men struation, the menopause, etc., when con gestion of the uterus and adnexa plays an active part in the morbid process.
CINCHONA.—Cinchona, or cinchona bark, was first brought to Europe some time in the seventeenth century, but just exactly when or how is not really known, though a great number of idle and fanci ful tales are extant that purport to ac count for its introduction. It was cer tainly employed medicinally as early as 1640, though its most prominent alka loid, quinine, was not discovered until 1820 (see QUININE).
Some thirty-six species of cinchona are recognized, and, when the number of hybrids is considered, the total is consid erably augmented; but at the same time only seven constitute the source of the principle "barks" and alkaloids of com merce, as follows:— Brown, pale, Loxa (or Loja) bark, ob tained from Cinchona officinalis and the varieties condaminea, bonplandiana, and crispa ; red bark, from C. succirubra ; gray, or silver, bark, from C. nitida, C. micrantha, and C. Peruviana; yellow bark, from C. calisaya and its variety Ledgeriana ; Columbian or Cartagenia bark, from C. lancifolia and C. cordi
folia ; Pitayo bark, from C. pitayensis ; and Cuprea bark from Remijia Purdi eana and R. pedunculata, the last two be ing forms seemingly intermediate as to the true and false cinchonas. All are evergreen trees or shrubs that favor and slopes at elevations varying from 400 to 11,500 feet above sea-level; they average from 30 to SO feet in height, and measure from 1 to 2 feet in diameter at the base. The leaves resemble those of the laurel, are entire, of varying shape, the best pitted—or with numerous small shallow depressions—on the (except C. succirubra) and a prominent mid-rib; flowers tubular, fragrant, rosy-white, or purplish; fruit capsule two-celled, splitting from the base upward, and containing many winged seeds. All are indigenous to the Andean region of South America, and the pale, red, and yellow barks constitute the chief imports; the cuprea-barks are .little used. Pale and red barks, the prod uct of cinchona plantations in India, instituted and fostered by the govern ment, are also obtained, arriving from Madras and other seaports on the Bay of Bengal. There are likewise plantations. in Ceylon, the Malay Peninsula, in South Africa, Jamaica in the West Indies, and a very rich form of Ledgeriana and cali saya is obtained by way of Amsterdam or Hamburg from the plantations of the Dutch Government in Java. Formerly the trees were felled close to the ground and stripped of bark, not even the branches escaping, but of recent years the discovery was made that a more profitable yield could be obtained by merely removing the bark in strips or sections from the standing tree, the de corticated portion being renewed if pro tected, and as rich in alkaloids as before; also that the yield of alkaloids could be materially increased by covering the bark with moss or matting, thereby prevent ing the rays of the sun from converting the alkaloids into coloring matter. Again, it has been found that by careful selection of favorable species, and by crossing and again selecting, barks may be produced that will yield double or even treble the quantity produced by the best non-hybrid varieties.