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    Medullary Emetic, Phlegm-Expelling & Amoebicidal Sovereign (涌吐风痰 / 化痰催吐截疟杀阿米巴原虫大毒峻药)

    吐根 / 吐根树 / 巴西吐根 / 柔毛吐根 — Carapichea ipecacuanha (Brot.) L.Andersson (syn. Cephaelis ipecacuanha)

    Pinyin: Tǔgēn / Tǔgēnshù · Malay: Akar Ipekak / Ipekak / Akar Muntah · Family: Rubiaceae (茜草科)

    Botanical Illustration

    Energetics

    Neutral to slightly Cool (平 / 微凉), Toxic in overdose (有毒)

    Flavor

    Bitter, acrid, nauseating (苦、辛、微恶心)

    Meridians

    Stomach (胃), Lung (肺), Large Intestine (大肠)

    Traditional Edict

    Johor Ipecacuanha. Cylindrical annulated root with bead-like rings. Powerfully induces therapeutic emesis to evacuate poisons, expels suffocating bronchial phlegm, and eradicates amoebic dysentery and liver abscesses.

    Cautions & Contraindications

    • CARDIOTOXICITY WARNING: Chronic repeated use accumulates in myocardium, causing irreversible cardiomyopathy and fatal cardiac arrest. ABSOLUTELY CONTRAINDICATED in corrosive chemical poisonings, petroleum ingestions, and comatose patients.

    Clinical Applications

    • Emergency gastric decontamination in oral non-corrosive toxic overdoses, pediatric suffocating croup (sub-emetic expectorant), and intestinal/extraintestinal amoebiasis (Entamoeba histolytica).

    Quality Markers

    Total Alkaloids >= 2.00%, Emetine >= 60.0% & Cephaeline >= 30.0% (USP/BP Pharmacopoeia Standard)

    Mechanism & Phytochemistry

    1. Cephaeline irritates gastric mucosal vagal sensory afferents, while emetine crosses blood-brain barrier to stimulate CTZ in medulla, triggering complete emesis in 15-30 min. 2. Sub-emetic doses stimulate bronchial seromucinous secretions. 3. Amoebicidal 40S ribosomal translocation arrest.

    Preparation & Dosage

    CRITICAL PROTOCOL: SYRUP OF IPECAC (0.14% alkaloids): Adults 15-30 mL with 1-2 glasses of water; Children 15 mL with water. (NEVER USE FLUID EXTRACT - 14x toxic). Sub-emetic expectorant root powder: 25-100 mg daily.

    Appended Prescriptions

    • 1. Historic Dover's Powder (Pulvis Ipecacuanhae et Opii) with Powdered Opium and Potassium Sulfate for fever diaphoresis. 2. The Sovereign Amoebic Dysentery Triad with Brucea javanica (Yadanzi).

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    Yemama Apothecary · Petaling Jaya, Malaysia · For educational and clinical reference only