(From vol. vi, 2nd edit.,1827)
(The best pieces of the bark of this South American tree, called Bonplandia trifoliata, are about one line in the thickness, slightly bent on their external convex side covered witha greyish- whitish, easily scraped off, fine coating; traversed by fine transverse furrows; on the inner concave surface of a bright brownish yellow, very friable, and cinnamon coloured and porous on the fractured surface; of a disagreeable spicy smell, and of a penetrating, somewhat hot, spicy bitter taste, the powder of which resembles rhubarb powder in colour; the decoction is not precipitated by a solution of sulphate of iron. Fifty grains of this powder digested in 1000 drops of alcohol without heat so as to form a tincture are employed for medical purposes after appropriate dilution.)
For many years complaints have been publicly made about a substitution in commerce for this true angustura bark of a false bark, which displays dangerous and poisonous properties, and for many years the tree from which this false bark was derived was unknown.
Now the Brucea ferruginea is said to be the tree from which this false suspicious bark is derived; chemical investigation has shown that it furnishes the same alkaloid as nux vomica, ignatia, & c.
However, the above-described genuine angustura bark likewise possesses uncommonly great medicinal power, so that, when is procured direct from the tree Bonplandia trifoliata at St. Thomas del Angustura, in South America, as it is now, without any doubt it can, like every other very powerful medicine, do great harm if given in immoderate doses and insuitable cases. In F.A.G. Emmert’s Curgeschichte (Hufeland’s Fourn., August, 1815, p.75) a case is related where three tablespoons of a decoction of five ounces of (presumably spurious) angustura bark, evaporated to five ounces of liquid, were given to a boy five and a half years old. This unreasonable dose, which contained about an ounce and a half of angustura power, proved fatal, as we read with a shudder, in a couple of hours, with horrible sufferings. This substance would in the same dose have a like effect not only on a boy but on an adult person.
In this fatal case described by EMMERT the boy presented this following symptoms:
Trembling, soon passing into violent convulsions (aft. ½ h.)
When the medical attendent touched the arm in order to feel the pulse tetanus suddenly ensued.
The eyelids were wide open.
The eyes were staring, projecting, and immovable.
Trismus, with wide separation of the lips, so that the front teeth were quite exposed.
Tension of individual facial muscles.
The limbs were stretched out to the utmost, stiff and stark.
The spinal column and the head strongly drawn backwards.
The trunk was from time to time shaken by violent jerking along the back, as from electric shocks, and somewhat raised.
Cheeks and lips became blue.
After an attack that lasted six minutes the boy breathed with great effort, panting with blueness of the cheeks and lips.
Great and frequent longing for coffee.
Even swallowing tepid water excited tetanic spasms.
Pulse 102, spasmodic, irregular.
The tetanus sometimes returned without perceptible cause, sometimes was excited by a noise, or by touching any portion of the body; he constantly called out that one should touch him.
After the tetanus the eyes were closed, the forehead and face covered with sweat; blueness of the cheeks and lips, groaning without (acknowledged) pains.
The whole body became flaccid and relaxed; the eye dead-like; convulsive breathing came back only after long pauses.
Death after an hour.
Half an hour after death the body was stiff and stark.
After twenty-four hours there was already a strong corpse-like smell outside and inside; on opening the veins cherry-coloured fluid blood was found.
The right lung was externally pale and bloated, internally full of blood; the left lung was externally blue, when incised blackish and very heavy from blood.
Besides the above other reports of the consequences of strong dosesof angustura have been recorded, such as spasmodic twitchings, vertigo, anxiety, immobility of the muscles as from stiffening, and a report has been communicated to me by late Dr. Wurzner, of Eilburg, relating to four persons, each of whom took from ten to twelve grains of the extract in the form of pills, in whom there occurred:
Stiffness of all the muscles of the body, like tetanus; one fell to the ground suddenly, retaining his consciuosness.
Closure of the jaws, trismus.