Rhamnaceae

Names: Sacred Bark, Chittem Bark, Cascara.

Habitat: Native to the Pacific Coast of North America.

Collection: The bark is stripped from the trunk of this tree in the spring and summer and left to age for a few years. Due to indiscriminate cutting by white settlers during the last century, the number of wild trees has been greatly reduced.

Part Used: Dried bark.

Constituents: Up to l05 anthraquinone glycosides, consisting of the cascarosides A, B, C and D, which account for about 70% of the total with other glycosides in minor concentrations, including barbaloin, frangulin, chrysaloin; glycosides based on emodin, aloe emodin, emodin oxanthrone, and chrysophanol, dianthrones including the heterodianthrones palmidin A, B and C and the freeaglycones.

Actions: Laxative, hepatic, bitter.

Indications: Cascara Sagrada may be used in chronic constipation as it encourages peristalsis and tones relaxed muscles of the digestive system.

Ellingwood considered it to be a bitter tonic specific for "chronic constipation." He recommends it in the following terms: "In prescribing Cascara for the cure of chronic constipation, large doses at the first are undesirable. If a single dose, so large as to produce a cathartic effect be administered, subsequent small doses will prove insufficient to restore tone and the constipation will remain unless the large dose is constantly repeated. If a dose of from two to ten drops in a proper vehicle be given, three, four or five times daily for many days, even if the constipation does not at first yield, the effects after a few days are usually salutary. There is a normal movement in the morning and the habit of regular evacuation can be soon fixed, as the agent is continued the dose may be slowly decreased until a single drop at each dose is given. Finally, a single small dose morning and night may be continued for a time and then stopped, the bowels continuing their normal action. If constipation pre-exists, it is well to give a simple laxative or to flush the bowels thoroughly with some other agent before beginning the use of this, to overcome the chronic condition. The results can be sooner obtained also by smaller doses. Large doses of the agent produce colic and are seldom needed. In the temporary constipation of pregnancy or in the convalescence of acute disease, doses of from 1/4 to 1/2 dram in a tonic mixture, preferably of malt extract, taken at the bed hour will be most satisfactory. Often a single dose followed by a glass of cold water on rising will have a salutary effect. This is true of constipation extending over a short period, not necessarily chronic. To produce an immediate effect as a physic, a dram of the fluid extract should be taken and it will probably induce some pain. The agent should not be used in this active form for its immediate effects during the pregnant term, as its irritating influence may be sufficient to produce miscarriage. It is a useful remedy in many cases of chronic indigestion and in chronic disease of the liver. It has been use in cirrhosis with the best of results. It is useful in jaundice with deficient excretion of bile and corrects catarrh of the bile duct. It is useful in diarrhoea, subacuteor chronic, depending on deficient liver action, and upon catarrhal and atonic conditions of the intestinal tract.

Combinations: Cascara Sagrada should be combined with carminatives to lessen any colic.

Preparations & Dosage: Decoction: put l-2 teaspoonfuls of the bark in a cup of water, bring to the boil and leave to infuse for l0 minutes. This should be drunk at bedtime.

Tincture: take 0.5-1 ml of the tincture at bedtime.