Library

Gentian and Other Bitters
Martindale's 24^th Part 1
Compiled and Edited by Ivor Hughes

Gentian (B.P.)
Gentian Root; Enzianwurzl; Raiz de genciana.
Dose: 0.6 to 2g. (10 to 30 grains)

The dried fermented rhizome and root of Gentiana lutea (Gentianaceae), containing not less than 33% of water soluble extractive. Incompatible with iron salts. Store in a dry place.

Foreign Pharmacopoeias.
In all pharmacopoeias examined except Ind., Mex., and U.S., but in U.S.N.F.
Ger., Nor., and Swed. allow also other species of Gentiana.
Jap, includes also Japanese Gentian, from
G. scabra, which may be used in place of Gentian.
Gentian (Ind. P.C.) is Indian Gentian from G. kurroo.

Uses. Gentian is a bitter and is used to stimulate gastric secretion and improve the appetite. It should be given from half to one hour before meals. It is usually administered as the compound infusion or compound tincture.

Elixir
Glycerinated Gentian Elixir (U.S.N.F.).
Gentian fluidextract 1 ml., taraxacum fluidextract 1.5 nil., compound cardamom tincture 6 ml., raspberry syrup 6 ml., sweet orange peel tincture 1.5 ml., phosphoric acid 0.5 ml., ethyl acetate 0.1 ml., glycerin 40 ml., sucrose 20 g., alcohol 10 ml., water to 100 ml. It is used as a vehicle for other drugs.

Extracts
Extract of Gentian (B.P.C.). Ext. Gent.
A soft aqueous extract prepared by maceration and subsequent evaporation of the menstruum.
It is used as a pill excipient. Store in a cool place.
Dose: 120 to 500 mg. (2 to 8 grains).
Several foreign pharmacopoeias include a similar extract, some using dilute alcohol as the menstruum. Cz. P., Jug. P., and Swiss P. have a dried extract.

Gentian Fluidextract (U.S.N.F.).
A 1 in 1 liquid extract prepared by maceration and percolation with a mixture of equal volumes of alcohol and water. Usual dose 1 ml. (15 minims).

Infusions
Compound Infusion of Gentian (B.P.). Inf. Gent. Co.
Concentrated compound infusion of gentian 12.5 ml., water to 100 ml. It should be used within 12 hours of preparation.
Dose: 15 to 30 ml. (0.5 to 1 fl. oz.).

Concentrated Compound Infusion of Gentian (B.P.). Inf. Gent. Co. Conc.
Prepared by macerating gentian, dried bitter orange peel, and dried lemon peel, about 10% of each, with alcohol (25%).
Dose: 2 to 4 ml. (30 to 60 minims).

Inf. Gent. Co. Rec. (B.P.C. 1949). Fresh Compound Infusion of Gentian.
Gentian 1. 25 g., dried bitter orange peel 1.25 g., dried lemon peel 1.25 g� and boiling water 100 g. Infused in a covered vessel for 15 minutes and strained.
Dose: 15 to 30 ml. (0.5 to 1 fl. oz.).

Mixtures
Acid Mixture of Gentian (B.P.C.). 'Mist. Gent. Acid. (B.N.F.).
Concentrated compound infusion of gentian 30 m., dilute hydrochloric acid 10 m., chloroform water to 112 fl. oz.
Dose: 15 to 30 mil. (0.5 to 1 fl. oz.).

Acid Mixture of Gentian with Nux Vomica (B.P.C.). Mist. Gent. Acid. c. Nuc. Vom.
Concentrated compound infusion of gentian 30 m., dilute hydrochloric sad 10 m., tincture of nux vomica 10 m., chloroform water to 0.5 fluid oz.
Dose: 15 to 30 ml. (0.5 to 1 fl. oz.).

Alkaline Mixture of Gentian (B.P.C.). Mist. Gent. Alk. (B.N.F.); Mist. Gent. c Soda.
Concentrated compound infusion of gentian 30 m, sodium bicarbonate 10 gr, chloroform water 0.5 fl. oz.
Dose: 15 to 30 ml. (0. 2 to 1 fl. oz.).
Precipitation. A precipitate may form if tap water is used in the preparation of the chloroform water. Removal of the precipitate would result in a loss equivalent to about 1.1% of the total sodium bicarbonate in the mixture, if very hard water (30� permanent hardness) had been used.
For London tap water (about 6� permanent hardness) the loss would be about 0.22%.
Pharm. Soc. Lab. Rep., Pharm. J., i/1956,383.

Alkaline Mixture of Gentian with Nux Vomica (B.P.C.). Mist. Gent. Alk;, c. Nuc. Vom.
Concentrated compound infusion of gentian 30 m., sodium bicarbonate 10 gr., tincture of nux vomica 10 m., chloroform water to 0.5 fl. oz.
Dose: 15 to 30 ml (0.5 to 1 fl. oz.).

Mist Gent Acid pro Infant (BPC 1949). Acid Mixture of Gentian for Infants; Mist Acid Amar pro Infant.
Concentrated compound infusion of gentian 4 m., dilute hydrochloric acid 11/4 m., chloroform water to 60 m.
Dose: 4 to 8 ml (60 to 120 minims).

Mist. Gent. Alk. c. Phenobarb. (B.N.F.). Gentian and Alkali Mixture with Phenobarbitone; Mist. Gent. Alk. Sed.
Concentrated compound infusion of gentian 30 m., Phenobarbitone sodium 1/4 gr., sodium bicarbonate 10 gr., chloroform water to 0.5 fl. oz. It must be freshly prepared. The quantity to be dispensed and the dose must be stated by the prescriber.

Mist. Gent. Alk. pro Infant. (B.P.C. 1949). Alkaline Mixture of Gentian for Infants.
Concentrated compound infusion of gentian 4 m., sodium bicarbonate 2 gr., chloroform water to 60 m. Dose: 4 to 8 ml. (60 to 120 minims).

Mist.Gent. c. Rheo (B.P.C. 1949, B.N.F.). Mixture of Gentian with Rhubarb; Mist. Gent. Alk. c. Rheo.
Concentrated compound infusion of gentian 15 m., compound tincture of rhubarb 15 m., sodium bicarbonate 10 gr., peppermint water to 0.5 fl. oz.
Dose: 15 to 30 ml. (0.5 to 1 fl. oz.).

Mist. Gent. c. Rheo (N.F. 1939) is the same as the above formula, but with concentrated infusion of rhubarb 15 m. in place of the compound tincture.

Mist. Gent. c. Rheo pro Infant. (B.P.C. 1949). Mixture of Gentian with Rhubarb for Infants. Concentrated compound infusion of gentian 2.5 m., compound tincture of rhubarb 2.5 m., sodium bicarbonate 2 gr., emulsion of peppermint 0.5 m., emulsion of chloroform 1 m., water to 60 m.

Dose: 4 to 8 ml. (60 to 120 minims)

Mist. Gent. c. Rheo pro Infant. (N.W.F. 1947). Concentrated compound infusion of gentian 2 m., infusion of rhubarb 15 m., sodium bicarbonate 2 gr., emulsion of peppermint 0.5 m., emulsion of chloroform 1 m., water to 60 m.

Dose; 4 ml. (60 minims).

Tinctures
Compound Tincture of Gentian (B.P. Egyp. P.). Tinct. Gent. Co.
Prepared by macerating, gentian 10 g., dried bitter orange peel 3.75 g., and cardamom seed 1.25 g, with alcohol (45%) 100 ml.
Dose: 2 to 4 ml. (30 to 60 minims). U.S.N.F. is similar but has about 10% of glycerin. Several foreign pharmacopoeia's , include a simple tincture (1 in 5).

Other Bitters.
Andrographis (B.P.C. 1949). Kalmegh (Ind. P.); Kiryat.
The dried entire plant (B.P.C. 1949) or the dried leaves (Ind. P.) of Andrographis paniculata (Acanthaceae). Ind. P. specifies not less than 1 % of a non nitrogenous bitter principle, andrographolide.
Uses. Andrographis usually in the form of a liquid extract, is employed in India as a bitter.
Liquid Extract of Kalmegh (Ind. P.). Ext. Kalm. Liq.; Liquid Extract of Andrographis.

An aqueous extract (about 1 in 2) prepared by boiling andrographis with water, concentrating the menstruum, and then adding the other ingredients. It contains 2% v/v of fennel oil, 2% v/v of ajowan oil, 55 to 60% of alcohol, and is adjusted to contain 0.5% w/v of andrographolide.
Dose: 0.5 to 1 ml. (8 to 15 minims)

Berberine Sulphate (B.P.C. 1949, Ind. P.)
Berberin. Sulph.; Berberine Acid Sulphate; Berberine Bisulphate. C₂₀H₁₉O₅N,H₂SO₄ = 451.5.
Dose: 60 to 300 mg. (1 to 5 grains).
The acid salt of berberine, an alkaloid present in hydrastis, in various species of Berberis, and in many other plants. It is mainly obtained from Berberis vulgaris and, in India, from B. aristata (Berberidaceae) and Coptis teeta (Ranunculaceae).
Bright yellow, odourless, acicular crystals or dark yellow powder with a bitter taste. Soluble 1 in 150 of water; slightly soluble in alcohol. Solutions are sterilised by autoclaving or by filtration.
Uses. It is given orally as a bitter. An injection of berberine sulphate is used in India in the treatment of oriental sore. It is injected subcutaneously around the margins of the lesion once a week; 2 to 5 injections usually cure.

Injection of Berberine Sulphate (Ind. P.). Inj. Berberin. Sulph.
A sterile solution in Water for Injection. Unless otherwise specified, a solution containing 20 mg, in 3 ml. is supplied.
Dose: By subcutaneous injection at various points around the sore

Calamus (B.P.C. 1934). Calam.; Calamus Rhizome; Sweet Flag Root; Acore Vrai; Kalmus.
Dose: 1 to 4 g. (15 to 60 grains).
Foreign Pharmacopoeias: In Cz., Ger., Hung., Jug., Nor., Pol., and Swiss. Also in Ind. P.C.
Pol. also includes the volatile oil.
The dried rhizome of the sweet flag, Acorus calamus (Araceae). It contains 1.5 to 3.5% v/w of a bitter, aromatic, volatile oil.
Uses. An aromatic bitter and carminative usually employed in the form of an infusion, 1 to 10 of boiling water; Dose: 15 to 30 ml. or tincture 1 in 5; Dose: 2 to 4 ml. The volatile oil is used in perfumery.

Calumba (B.P.C.). Calumb.; Calumba Root; Colombo.
Dose: 0.6 to 2 g. (10 to 30 grains).
Foreign Pharmacopoeias: In Belg., Egyp., Fr., Ger., Jap., Nor., Span., Swed., and Swiss.
The dried transverse or oblique slices of the root of Jateorhiza palmata (Menispermaceae), containing not less than 15% of water soluble extractive. Store in a dry place.
Uses. A simple bitter for use in atonic dyspepsia associated with hypochlorydria. It contains no tannin and can be given with salts of iron.

Inf. Calumb. (B.P. 1948). Infusion of Calumba.
Concentrated infusion of calumba 12.5 ml., water to 100 ml. It should be used within 12 hours of preparation.
Dose: 15 to 30 ml. (0.5 to 1 fl. oz.).

Inf. Calumb. Conc. (B.P. 1948). Concentrated Infusion of Calumba.
An extract ( 1 in 2.5 ) prepared by macerating calumba with water. It contains 21 to 24% v/v of alcohol. Dose: 2 to 4 mil. (30 to 60 minims).

Inf. Calumb. Rec. (B.P. 1945). Fresh Infusion of Calumba.
Calumba 5g. and cold water 100 ml, infused in a covered vessel for half an hour and strained.
Dose: 15 to 30 mil. (0.5to 1 fl. oz.). It should be used within 12 hours of its preparation.

Tinct. Calumb. (B.P. 1948, Egyp. P.). Tincture of Calumba.
1 in 10; prepared by macerating with alcohol (60%).
Dose: 2 to 4 ml. (30 to 60 minims). Fr and Span. P. have 1 in 5.
 

Cascarilla (B.P.C. 1949). Cascarilla Bark.
Foreign Pharmacopoeias: In Dan., Egyp., Nor.

The dried bark of Croton eluteria Euphorbiaceae containing not less than 1.5% v/w of volatile oil.

Powdered Cascarilla (B.P.C. 1949) contains not less than 1%, v/w of volatile oil. Store in a cool, dry place.

Uses. An aromatic bitter usually administered as an infusion or tincture. Cascarilla is also used in fumigating compounds on account of its aromatic odour while burning.

Inf. Cascaril. Conc. (B.P.C. 1934).
Concentrated Infusion of Cascarilla.
About 1 in 2.5 prepared by macerating with alcohol (25%).
Dose: 2 to 4 mil. (30 to 60 minims).
Infusion of Cascarilla may be prepared by diluting the concentrated infusion with 7 times its volume of water.

Tinct. Cascaril. (B.P.C. 1949). Tincture of Cascarilla.
1 in 5; prepared by percolating with alcohol (70%).
Dose: 2 to 4 mil (30 to 60 minims).

Chirata (B.P.C. 1949, Ind. P.). Chirat.; Chirayta; Chiretta; East Indian Balmony.

Dose: 0.3 to 2 g. (5 to 30 grains).
The Plant Swertia chirata (Gentianaceae) collected when in flower and dried.
Uses. A simple bitter. It is usually administered as a concentrated in-fusion or as a tincture, either of which may be prescribed with iron since they are free from tannin.

Compound Infusion of Chirata (Ind. P.). Inf. Chirat. Co.
Concentrated compound infusion of chirata 12.5 ml., water to 100 ml. It should be used within 12 hours of its preparation.
Dose: 15 to 30 ml. (0.5 to 1 fl. oz.).

Concentrated Compound Infusion of Chirata (Ind. P.).
Prepared from chirata 10 g., dried orange peel 10 g., lemon peel 20 g., and alcohol (25%) 120 ml., by maceration.
Dose: 2 to 4 ml. (30 to 60 minims).
Inf. Chirat. Conc. (B.P.C. 1949). Concentrated Infusion of Chiretta.
Prepared by percolating chirata 40 g., with alcohol (25%) to 100 ml.
Dose: 2 to 4 ml. (30 to 60 minims).

Tinct. Chirat. (B.P.C. 1934). Tincture of Chirata.
Prepared by percolating chirata 10 g. with alcohol (60%) to 100 ml.
Dose: 2 to 4 ml. (30 to 60 minims).
Ind. P. includes a compound tincture (about 1 in 10) with dried orange peel wool cardamom, prepared by maceration with alcohol (45%).

Condurango (B.P.C. 1934). Conduran.; Condurango Bark; Eagle vine Bark.
Dose: 1 to 4 g. (15 to 60 grains).
Foreign Pharmacopoeias: In Belg., Dan., Fr., Ger., Jap., Nor., Span., Sired, and Swiss.
The dried stem-bark of Marsdenia condurango (= Gonolobus condurango) (Asclepiadaceae). It contains a poisonous glycoside, or mixture of glycosides known as condurangin.
Uses. It has been used as an aromatic bitter and gastric sedative in the form of a liquid alcoholic extract (1 in 1)
Dose: 0.6 to 4 ml., and as a wine (1 of liquid extract in 10 of detannated sherry) Dose: 15 to 30 ml.