Alstonia constricta

Volume I — Appendix

{Bitter Bark.)

Description. — A tall shrub or tree, belonging to the order of Apocynacese, indigenous to the colonies of New South Wales and Queensland. Preparation. — Tincture of the bark. Triturations of Alstonin.

Invariably produces great debility and general prostration. Low fever often, with diarrhoea. When pushed sufficiently far, rigors, sweats (usually cold), and other symptoms resembling fever and ague. (Cathcart.)

° Intermittent fever, especially after the abuse of quinine.

° Great debility during convalescence from acute diseases of every kind.

0 Summer diarrhoea in hot climates, with passage of undigested food.

° Malarial dysentery, or from bad water impregnated with decayed vegetable matter. c Camp diarrhoea and dysentery of soldiers. ° Atonic diarrhoea. 0 Typho-malarial fever?

Volume II — Special Therapeutics

This remedy was introduced to our school by Dr. Augustus Cathcart, of Australia.

The Alstonia constricta belongs to the order of Apocynese. It

grows in the form of a tall shrub or tree, and is known by the name of “Bitter Bark.” It is indigenous to the colonies of New South Wales and Queensland, being found in the interior in some of the “scrubs,” and occasionally in the open forests. The portion used in medicine is the bark, which is thick, yellow, deeply fissured, and of an intense bitterness. A few of the shepherds in the interior have somehow or other (probably from accidentally finding out its bitterness, or by direction of the natives) discovered its use in fever and ague, and some of them, in addition to calling it the “ Bitter Bark,” call it “Native Quinine Bark,” as they look upon it as possessing properties similar to those of Quinine. As a remedy for fever and ague they use it in decoction, so I was informed by an old up-country shepherd, who first made me acquainted with it.

“An esteemed friend in Queensland,” says Dr. Cathcart, “has, at my request, carefully watched the effects of this drug upon 1 beer topers’ — those who had drank large quantities of a certain beer which had been adulterated with this bitter drug as a cheap substitute for the hop. From the effects which he observed, and from those produced in other persons whom I have prevailed upon to take large doses of this drug while in robust health as a ‘ proving,’ and those produced in my own person, I have abundantly satisfied myself that, in large doses, its action is that of invariably producing great debility and general prostration, or low fever, — often also with diarrhoea, — and, when pushed sufficiently far, rigors, sweats (usually cold), and other symptoms resembling fever and ague.

“Taking the large dose effects as my guide, I have used this remedy with far greater success than China in convalescence from acute diseases of every kind, even to post-diphtheritic and postscarlatinal debility , and the debility following parturition, underlactation, diarrhoea, etc.

“In the great majority of all those other cases where China is indicated I have found the Alstonia a more efficacious and far more reliable remedy. This use of it would alone stamp it as an invaluable remedy in all countries where patients have already been overdosed with Quinine at some time or other by allopathic practitioners.

“ In cases of summer diarrhoea (in this hot climate), where undigested food is passed, more especially, and even when tinged with blood, I have found it specific.

“ I have used it in cases of dysentery with success, especially where I thought the attack was complicated with symptoms of malarial poisoning, or proceeded from drinking bad water, or swamp- water impregnated with decayed vegetable matter — a frequent source of dysentery. Indeed, I have found it such a specific for these cases that I am confident it will prove the best remedy yet introduced for camp diarrhoea and dysentery of soldiers, when proceeding from this cause.

“ In simple atonic dyspepsia, with loss of appetite, etc., its action is very satisfactory.

“ In fever and ague, and in low fevers, especially those following upon attacks of acute disease, its extraordinary powers are manifested. For these it will be found a more reliable remedy than Quinine, Berberinum, or Chinoidin; and, moreover, not being so liable to affect the head, it may be confidently regarded as a perfectly safe antiperiodic and also a preventive of ague.

“ In carrying out and confirmatory of the rule of the dose which I have adopted, I find that it takes comparatively large (homoeopathic) doses to cure fever and ague, a weak decoction being the most reliable form, perhaps, or even nauseous doses of the mother tincture. Other cases require from the mother tincture to the 2d decimal dilution, in from one to five-drop doses, according to the strength of the disease and the age and susceptibilty of the patient. Being of a very bitter and unpleasant taste to some people, the dose has to be diluted with plenty of water, and sometimes reduced for those patients who have a great repugnance to bitters of any kind.

“ I make my mother tincture from the coarsely-powdered bark, using rectified spirits, in the proportion of one pint of spirits to two ounces of bark, and this tincture I invariably carry in my pocket-case.”

Since Dr. Cathcart’s notice was written, several physicians in the United States have used the Alstonia with good results in the class of cases mentioned by him. Dr. Grosvenor, of Chicago, and Dr.

K - , of St. Louis, report favorably. A fragmentary proving

has been made.

The bark of Alstonia constricta, F. v. M., contains an alkaloid, Alstonin, which may be obtained by treating the alcoholic extract with water and a little hydrochloric acid, adding to the filtered solution a small excess of ammonia, dissolving the Separated flocks in ether, evaporating the ethereal solution, and purifying the remainder by dissolving again in dilute acid, and repeating the above process. Orange-yellow, brittle, pellucid mass of very bitter taste, melts below 100° C., and is carbonized in higher temperature; dissolves easily in alcohol, ether, and dilute acids, sparingly in water. All its solutions in the dilute state exhibit a strong blue fluorescence, which is not affected by acids or alkalies. Its alcoholic solution has a slightly alkaline reaction. Alstonin combines with acids, but does not completely neutralize them. Hydrochloric and other strong acids, also alkalies, decompose it partly on evaporation in the water-bath to a dark-colored acid substance.