Elaterium
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Elaterium is the name of a drug consisting of a sediment deposited by the juice of the fruit of Ecballium Elaterium, the squirting cucumber, a native of the Mediterranean region.
The plant, which is a member of the natural order Cucurbitaceae, resembles the vegetable marrow in its growth. The fruit resembles a small cucumber, and when ripe is highly turgid, and separates almost at a touch from the fruit stalk. The end of the stalk forms a stopper, on the removal of which the fluid contents of the fruit, together with the seeds, are squirted through the aperture by the sudden contraction of the wall of the fruit.
To prepare the drug the fruit is sliced lengthwise and slightly pressed; the greenish and slightly turbid juice thus obtained is strained and set aside; and the deposit of elaterium formed after a few hours is collected on a linen filter, rapidly drained, and dried on porous tiles at a gentle heat. Elaterium is met with in commerce in light, thin, friable, flat or slightly incurved opaque cakes, of a greyish-green color, bitter taste and tea-like smell.
The drug is soluble in alcohol, but insoluble in water and ether. The official dose used to be 1-1/2 grain, and the British pharmacopeia at the beginning of the 20th century directs that the drug is to contain from 20 to 25% of the active principle elaterinum or elaterin. A resin in the natural product aids its action. Elaterin is extracted from elaterium by chloroform and then precipitated by ether. It has the formula C32H44O7. It forms colorless scales which have a bitter taste, but it is highly inadvisable to taste either this substance or elaterium. The British pharmacopeia contains a useful preparation, the Pulvis Elaterini Compositus, which contains one part of the active principle in forty.
The action of this drug resembles that of the saline aperients, but is much more powerful. It is the most active hydragogue purgative known, causing also much depression and violent griping. When injected subcutaneously it is inert, as its action is entirely dependent upon its admixture with the bile. The drug is undoubtedly valuable in cases of dropsy and Bright's disease, and also in cases of cerebral haemorrhage, threatened or present. It must not be used except in urgent cases, and must invariably be employed with the utmost care, especially if the state of the heart be unsatisfactory.