The Physiomedical Dispensatory by William Cook, M.D., 1869    

CAPSICUM ANNUUM

CAPSICUM, CAYENNE PEPPER, RED PEPPER

Description:  Natural Order, Solanaceae. Genus CAPSICUM:  Herbaceous annuals, one to three feet high. Stem crooked, smooth, branched above. Calyx five-cleft, erect, persistent; corolla white, tube very short, limb plaited, on axillary and long peduncles. Leaves long-stalked, ovate or oblong, nearly entire, sometimes in pairs. Fruit capsular, inflated, scarlet or yellow, variegated with orange or green, variable in size and shape–oblong, round, cordate; seeds numerous, whitish yellow, flat.  C. ANNUUM:  Stem angular; leaves ovate-acuminate, entire, smooth; calyx angular, with short acute lobes; fruit (berry, incorrectly called pod) tapering- oblong, very smooth, bright red.  There are several garden varieties of this plant, in addition to this one; in some of which the fruit is small, orange, nearly globose, and much wrinkled, and in others very large, cordate, deeply-furrowed longitudinally, and dull red or dark green.

The Guinea or African Pepper, called also Bird’s-Eye Pepper, is the true officinal article, and the one possessed of the greatest medicinal powers; though the small American species with the smooth and tapering fruit, is nearly its equal. The African species is the Capsicum fastigiatum; and is of a shrubby instead of herbaceous growth. Its capsule is rarely an inch long, of a deep orange-red, shining, wrinkled, pointed at both ends, and about two lines broad. The above species annuum is, in the ground state, nearly always substituted for the fastigiatum; but the round capsules, and the large heart-shaped ones, are much more feeble than the tapering ones.

Capsicum is not a true pepper; but its taste somewhat resembles the peppers, and hence the popular language has attached that name to it. Its capsules, including the seeds, are the most intensely pungent and lasting of all the spices. Its powers depend chiefly upon a soft resin and an oil, both of which are acrid. It yields its entire properties to 98 percent alcohol and to ether; less completely to any dilutions of alcohol; to a very considerable extent to vinegar; largely (but not completely) to water; but solutions of the caustic alkalies, as of potassa and soda, act upon it almost as well as alcohol.

Properties and Uses:  The fruit is one of the purest of all known stimulants, of great intensity, very permanent in its action, spreading through the system rather slowly, but ultimately reaching every organ of the frame. It creates a sensation of warmth, and finally of biting pungency, in the mouth, stomach, skin, or other part to which it is directly applied. When used in a considerable dose, it excites the stomach strongly, yet is diffused so slowly that for a time it disturbs the equilibrium of circulation and nervous action between the stomach and the adjacent parts; and hence large quantities may be followed, for a short time, by hiccough, and even by a cramping pain in the stomach.

It acts mainly upon the circulation, but also upon the nervous structures. It first shows its power upon the heart and the large and central blood vessels; but finally traverses from the center to the very capillaries. It thus slowly gives increased tone to the circulation–not so materially increasing the frequency of the pulse, as giving power to each pulsation. In cases where the pulse is enfeebled and very much hurried from putrescent tendencies, as in typhus, malignant scarlatina, phlegmonous erysipelas, gangrenous wounds, threatened absorption of pus, etc., capsicum may be used in full quantities, and will be followed by diminished frequency but greater firmness of the arterial action.    

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    The Physiomedical Dispensatory by William Cook, M.D., 1869    

This agent is fitted for all forms of depression and atony, especially where these are dependent upon feebleness of either general or local circulation, or loss of nerve power not connected with local irritability. The stomach is directly aroused by its action; and will be much improved by its use in those forms of indigestion connected with torpor, sluggishness, and loss of sensibility. In such conditions, it is generally combined with tonics, especially with the more relaxing tonics, as boneset, liriodendron, etc. Combined in small quantities with cathartics, it increases their intensity, and prevents the griping of many of them; and in typhoid and similar cases of depression, such relaxing hepatics as leptandrin or euonymus should always be combined with some capsicum. Its own steady stimulation of the bowels many times leads to defecation; and persons suffering costiveness from a semi-paralyzed condition of the alvine canal, often do best by omitting cathartics and using a large dose of capsicum daily. By sustaining the portal circulation, it is of the greatest value in all forms of ague, except distinct gastric intermittents. In the most obstinate forms of this malady, capsicum alone has effected cures after antiperiodics had been used in vain; and its combination with quinia meets an important indication that can not be filled by the latter article. In congestive chills, large or even enormous doses of capsicum are invaluable, and are as potent in relieving the oppressed circulation as quinine is the agitated nerves of such cases. The secernents all feel the beneficial effects of the article; and alterative preparations designed for secondary syphilis, mercurial poisoning, etc., where the tone of the system is much impaired, should receive a small portion of it. In degenerate coughs, with a too abundant and tenacious expectoration; in chronic torpor of the kidneys, with a cold skin and sluggish pulse; in uterine atony, general dropsy, and all similar cases of inefficiency and loss of power, the capsicum is almost a necessity–added to the class of agents suitable to the case, for the purpose of so arousing the parts that they will respond to the impressions of the other remedies. (§260.)

This agent is also one of the most powerful arrestors of mortification that the Materia Medica contains. To this end it acts in two ways: Ist. By virtue of its antiseptic qualities, which are well known to arrest decomposition even in dead substances.  2d. By its great influence in sustaining the circulatory apparatus; whence it will maintain the best possible flow of blood through every part, procure an early and advanced line of demarkation when gangrene is no longer avoidable, and repel all products of putrefaction so that they will not be absorbed. By these invaluable qualities, it is an agent of great service in all diffusive preparations for the treatment of typhus, receding small-pox, scarlatina, diphtheria, putrid sore-throat, phlegmonous erysipelas, yellow fever, and similar maladies with a putrescent tendency. The quantity given will of course depend on the stage of the malady and the degree of depression; but in malignant cases, where the danger is great, the only error the physician is likely to commit, will be in not giving enough. In malignant scarlatina and diphtheria, it should be used liberally both in drink and as a gargle; while in epidemic erysipelas, the last stages of puerperal metritis, when the effusion of peritonitis or pleuritis has set in, or when pyraemia is about to occur after an operation or from an erysipelatous abscess, the quantity given should be limited only by the patient’s ability to receive it. When the black vomit of yellow fever sets in, small and frequent doses will usually stop the emesis by arresting the process of decomposition.  For a similar reason, and by virtue of its power to sustain the blood toward the surface, it is a. valuable adjunct in the treatment of cholera. It relieves engorgement of the lungs and uterus, and is of much service in arresting hemorrhages from these and other internal organs. It arouses the vascular system when other agents refuse to act at all; and is superior to any and all agents in what would otherwise be hopeless cases of uterine hemorrhage, bleeding after typhus, etc. It is then generally combined with myrica or other stimulating astringent, and with some prompt diffusive. In the collapsed stage of cholera, of yellow fever, of all clammy sweats; also in asthmatic asphyxia and collapse from burns or other profound shock of injury, it is one of the best agents to secure full reaction. In these and all other cases where pain of a. heavy character arises in consequence of approaching gangrene, capsicum relieves the suffering by arresting the decay.(§238.)  In the same manner, it relieves the extreme restlessness which usually accompanies such conditions; on which account it is associated with lobelia and cypripedium to secure an antispasmodic action.(§245.)  Also in delirium tremens it is the best of all stimulants, in combination with nervines; and is valuable locally in bleeding piles.

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    The Physiomedical Dispensatory by William Cook, M.D., 1869    

As an outward application, capsicum makes one of the best bases of all stimulating liniments. It arouses a strong circulation upon the surface, inducing smarting and redness. It has been pronounced capable of blistering, but this I believe is a decided mistake. Indeed it has a great advantage over all vesicating agents, in the fact that it can be applied to any desired extent, without injuring the skin. In suitable forms, it makes an external remedy of the greatest value for all internal inflammations and congestions, such as dysentery, pneumonia, pleurisy, peritonitis, congestion of the uterus, ovaries, liver, spleen, or kidneys, painful menstruation, irritation of the stomach, etc. This is a large list, but these maladies are all of one class; and the practitioner will lose one of his most powerful means of restoring a balance to the circulation, if he fail to use capsicum over the seat of the congestion. And it should also be used freely–deep congestions bearing enormous quantities of it before it is felt. The Stimulating Liniment is one of the best forms of application. In ague-cake and some other cases, where a slow action is required, it is made into a poultice with demulcents; and it is also used with oleo-resins in making stimulating plasters. It is one of the best agents, both outwardly and by the stomach, in paralysis; and may be applied as a wash, (or mixed with some relaxing extract, or in flour paste,) and used as a plaster in deep paralysis and overwhelming spinal congestion, to the entire length of the spine. In typhus, acute meningitis, phrenitis, and such cases where there is an overwhelming determination of blood to the brain, and the extremities become almost icy cold, it is of much service to apply capsicum, sprinkled on stiff mush or something of the kind, to the soles of the feet. They may be kept on as long as the patient does not complain of them, and renewed at intervals. In putrid difficulties about the throat, its liberal outward application should never be omitted. The Stimulating Liniment is a good form for using it; or the powdered article may be laid thickly upon a slice of raw and salt fat pork, and bound upon the throat. This last is a powerful and valuable application.

Locally, capsicum is an indispensable agent in phagedrenic, malignant, and truly indolent ulcers and carbuncles; in all sloughing sores and on all gangrenous surfaces; and as a gargle in scarlatina, diphtheria, mercurial sore mouth, and all other putrid conditions. For gargling purposes, it is usually combined with such agents as hydrastis, myrica, myrrh, and other stimulating tonics–the capsicum being in smaller proportions, and in such quantities as the case demands.

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    The Physiomedical Dispensatory by William Cook, M.D., 1869    

This agent is rarely used alone, but is generally combined with an excess of other articles. It contains an unusual amount of power in a small bulk, hence its proportion is to be greatly less than that of the accompanying agents. As its own power of diffusion is moderate, it is best to combine it with more relaxing and diffusive articles. When its action toward the surface is sought, it is best combined with such diffusives as asclepias and ginger. It gives intensity to such emmenagogues as hedeoma, caulophyllum and cimicifuga; and the power and promptness with which it acts when in company with cypripedium and lobelia, are truly astonishing.(§260.) Half a grain to two grains, given in demulcents by injection, act with great power toward the surface in cholera, apoplexy, congestive chills, and other forms of collapse.

While an unusual amount of praise has thus been ascribed to capsicum, it is not to be supposed that it can be used everywhere that a stimulant is required. It is best when limited to severe cases; and milder and more diffusive stimuli should always be selected for mild forms of depression; but when decided prostration is advancing, capsicum is superior to all other agents of its class. It should never, however, be used needlessly or without discrimination. A full and hard pulse does not admit it; though a creeping, wiry, unsteady and very small pulse calls for it. It is out of place altogether in inflammatory fever or any inflammatory condition; in gastric irritation, or inflammation, in acute sensitiveness of the throat and lungs, in a hot and burning skin with a large pulse, and in any and every similar condition. It is as much out of place under such circumstances, as fire would be in July, with the thermometer at 100E.  It has many times been used with the greatest lack of judgment in such conditions; but such practice is neither rational nor successful. The vast powers and virtues of the agent are not sufficiently known and appreciated; but it will not advance its reputation, nor the cause of science, to attempt its indiscriminate employment. It is proper to add in this place that Dr. Samuel Thomson was mainly instrumental in giving this remedy its true position in the Materia Medica. Frequent reference is made to it in the department of Therapeutics, which see.

The dose of the article is usually about one grain. In compound infusions, where the preparation is given at moderate intervals, it is seldom that the strength of more than one-tenth to one-fourth of a grain is given at a dose. As vitality diminishes, the portion may be increased to one or two grains every two hours; or even much larger portions in extreme cases, till its action begins to be manifested. In tonic compounds, one-fourth of a grain, three or four times a day, is usually sufficient. One to two grains, with quinine, make a full dose for ordinary anti-periodic purposes; but congestive chills may require from four to even five grains every three or four hours. It is most commonly given in some fluid form. When used as a powder, it should always be mixed with some mucilage: that of gum tragacanth is best; but elm, gum arabic, thick boiled starch, or even good molasses, will do. It is often incorporated in pills.

Pharmaceutical Preparations:  Capsicum enters in the standard Composition Powder; and into the Compound Tinctures of Myrrh, Lobelia, etc. The more distinct preparations worthy of notice at this place, are the following :

I. Infusion. Capsicum, twenty grains; boiling water, one pint. Infuse in a covered vessel for an hour. Dose, half a fluid drachm or upward, at such intervals as the case may require. A much stronger infusion is commonly directed, but this is sufficient for all ordinary cases..

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    The Physiomedical Dispensatory by William Cook, M.D., 1869    

II. Tincture. Capsicum, in powder, one ounce; diluted alcohol, one quart. Macerate for fourteen days, and filter; or treat the capsicum by percolation. This preparation is used mostly upon the surface and as a gargle; but may be used inwardly in doses of half a fluid drachm or more, in any mucilage. A drachm of this tincture to a pint of simple sirup is called Sirup of Capsicum, and is a good preparation. Diluted alcohol does not extract the full properties of the article; and the dregs may be used as a local application, or treated with vinegar in preparing gargles. The standard tincture that I commend in all outward appliances, is made of capsicum, two ounces; absolute alcohol, one quart; macerate for two weeks.

III. Compound Acetous Tincture. Capsicum, two drachms; myrrh and hydrastis, each, four drachms; salt, two drachms; cider vinegar, one pint. Macerate the crushed articles at a gentle heat for seven days, and strain. This is one of the most effective of stimulating and antiseptic gargles and washes for all putrid conditions, as in diphtheria, scarlatina, etc. It is also useful many times in allaying the vomiting of cholera and yellow fever. To be used in such quantities as each particular case dictates.

IV. Stimulating Liniment. Into one quart of the tincture of capsicum on absolute alcohol, prepared as above, shave two ounces of white castile soap. Maintain at a gentle heat, with frequent agitation, till the soap is all dissolved. (See Soaps.) Then add half an ounce each of the oils of origanum, abies, and sassafras. Or the soap may first be dissolved in the alcohol, and afterward one ounce of capsicum added and tinctured in the usual way, and the oils added subsequently. This latter method has the advantage of securing the double solvent power of the alcohol and the caustic alkali on the capsicum. The liniment thus prepared, is one of the most powerful and satisfactory I have ever used. It contains no resinous materials to obstruct the surface; and the form of alkali here used improves the action of the capsicum on the surface, and is altogether preferable to ammonia–which is not a solvent to capsicum. This liniment may be used wherever the external use of capsicum is called for. Its action may be intensified, in obstinate cases, by following the appliance with flannels wrung out of hot water, or out of hot soap-suds. I first published this formula in 1852; since which time it has been modified in almost innumerable forms by physicians, and especially by incorporating with it ammonia, turpentine and camphor; but I consider such additions objectionable. It is a “pain killer,” (§239,) and may be used inwardly. For less stimulating purposes, tincture of capsicum may be added to tinctures of xanthoxylum, lobelia, cypripedium, etc.; and such oils as those of absinthium, rosemary, and monarda used according to the objects intended. All tinctures for liniments should be upon absolute alcohol.

V. Compound Soap Liniment. Tincture of capsicum and tincture of lobelia, each, half a pint; shavings of common hard soap, three ounces. Digest at a low heat in a close vessel on a sand-bath, till the soap is dissolved; and then add a drachm each of the oils of rosemary and spearmint, and half a drachm of the oil of wormwood. Pour into wide-mouthed bottles as soon as the oils are dissolved. When cold, this makes a jelly-like liniment, or opodeldoc; and is an excellent preparation for old bruises, chronic rheumatism, neuralgia, and other affections requiring a stimulating and nervine treatment.

VI. Oil of Capsicum. Pack tightly into a cylindrical percolator, three-fourths of a pound of coarsely-powdered capsicum. Treat it with ether till twenty-four fluid ounces have passed. Distill this on a water-bath till eighteen ounces of ether have been recovered; and then evaporate all the ether from the remainder. A fatty matter rises on the surface after a time, and this may be removed by filtering through muslin. The oleoresin (called oil) that remains, should be preserved in close bottles. It is a thick, dark brownish-red fluid, exceedingly pungent; soluble in ether and alcohol, only slightly soluble in water. It is too concentrated to use by itself; but may be diluted with a sufficient quantity of alcohol and used in liniments.

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    The Physiomedical Dispensatory by William Cook, M.D., 1869    

 Medical Herbalism journal and medherb.com