The drug is very rapidly absorbed into the circulation, and is eliminated chiefly by the kidneys and respiratory tract, and to some extent by the skin.
The elimination of copaiba by the lungs is insignificant and almost ni/. Binet (Revue Med. de la Suisse Rom., July 30, '93).
Binet's conclusions, however, cannot be accepted as final, and are not borne out by evidence.
Copaiba Poisoning.—Copaiba is cer tainly toxic, though there is no definite evidence of its ever having been a direct cause of death. Indirectly it is accused of g,iving rise to severe manifestations resembling rheumatic seizures and to renal dropsy. The toxic symptoms are those accruing to large or long-continued doses, greatly exaggerated, along with weakening of arms, of muscles, of face; paralysis; desquamative and pustular eruptions, and, more rarely, tetanoid seizures.
The drug has a manifest effect upon the skin and is likewise an epithelial irritant; but its action appears to be greatly influenced by individual suscep tibility. Assuming tha.t symptomatic dermatitis ensues as part of a general excretory action, the pra.ctical conclu sion must be that all drugs which pro duce eruptions should be prescribed with caution lest they injure other organs. Walsh (Med. Press and Circ., No. 3053, '97).
Treatment of Copaiba Poisoning.— The toxic symptoms are rarely such as to require measures other than with drawal of the drug and the promoting of excretion by all the emunctories. Diuretics and cathartics may be em ployed, and cannabis Indica or opium used to allay pain.
Therapenties.—As a whole, copaiba promises little therapeutically that can not be more palatably and easily ob tained through the use of oleoresin of cubeb, oil of turpentine, and other agents of this class. If prescribed, it is
best given in capsules, preferably dis solved in some bland oil. It frequently appears in capsular form in conjunction with oil of sandal-wood, or eucalyptus, or cubeb. In mixtures its nauseousness may, in part, be overcome by the use of spirit of chloroform, chloroform-water, and aromatics. The oil is, in every way, a preferable preparation to the oleoresin, being a more constant and definite agent.
GoNoRnHcEA.—Tt is in tbis malady that copaiba has found chief employ ment, solely because of its antiseptic properties and affinity for mucous tis sues; and for all that many practitioners in the management of this malady still rely on this drug, alone or in conjunction with other diuretics or drugs of the same class. It is much overrated, and its real merits are nowise compensatory for the nausea and disagreeable sequels that fol low in its train. Again, the uncertainty attending the character of the drug per se is such that oleoresin cubeb, which is equally effective, is a more desirable remedy, although perhaps less diuretic, but even in this respect it may be ren dered superior to copaiba by the addi tion of an extremely minute quantity of cantharides. Copaiba is also used as a urethral injection.
LEUCORRHCEA.—The internal admin istration of copaiba often seems bene ficial in the fluxes of females, and also the pudendal eruptions that accrue to or are sequels of these discharges.