Squill

Squill

It is a very variable plant, the bulb differing greatly in size and colour, and the leaves of the flower presenting similar varieties, which has led to the formation of several species, about twenty-five species having been described. Two varieties of Squill, termed respectively white and red, are distinguished by druggists. In the first named, the bulb scales are whitish or yellowish in colour, whereas the red species has deep, reddishbrown outer scales and yellowish white inner scales, covered with a pinkish epidermis, intermediate forms also occurring. No essential difference exists in the medicinal properties of the two kinds.

The White Squill, collected in Malta and Sicily, is preferred in England, while the Red Squill, collected in Algeria, is used in France. Both varieties are mentioned by Pliny and other ancient writers: the white is more mentioned in mediaeval literature, though the medical school of Salerno preferred the red variety of the drug.

The United States Pharmacopoeia defines the drug Scilla as the inner scales of the bulb of the white variety of Urginea maritima (Linn.).

Scilla, the classical name of the plant, is derived from a Greek word meaning to excite or disturb, as an emetic does the stomach. Scilla maritima was the name given by Linnaeus, but this was changed to Urginea, in allusion to the Algerian tribe Ben Urgin, near Boma, where Steinheil in 1834 examined this plant, removing it from the genus Scilla. The main difference between the genera is that the genus Urginea has flat, discoid seeds, while in Scilla proper they are triquetrous (threeangled, with three concave faces). Baker named it Urginea maritima, but it now retains Scilla as its specific name.

As seen in commerce, the undried bulb is somewhat pear-shaped, and generally about the size of a man's fist, but often larger, weighing from 1/2 lb. to more than 4 lb.

It has the usual structure of a bulb, being formed of smooth juicy scales, closely wrapped over one another. It has little odour, but its inner scales have a mucilaginous, bitter, acrid taste, owing to the presence of bitter glucosides.

In its home, it is frequently used fresh, but in other countries it is directed by the pharmacopoeias to be deprived of its dry membraneous outer scales (which are destitute of activity), cut into thin, transverse slices and carefully dried, either in the sun, or by artificial heat, the inmost part being rejected, as this central portion, being the youngest growth, is deficient in activity.

Owing to the mucilaginous nature of the tissue, drying is tedious and difficult. When fresh, the bulb abounds in a viscid, very acrid juice, which is capable of causing inflammation of the skin. On drying, the bulb loses four-fifths of its weight, and its acridity is largely diminished, with slight loss of medicinal activity.

Squill is generally imported in ready-dried slices, packed in casks, from Malta, where the largest collections are made.

The dried slices are narrow, flattish, curved, yellowish-white, or with a roseate hue, according to the variety of Squill from which they are obtained, from 1 to 2 inches long, more or less translucent.

When quite dry, the strips are brittle and can easily be powdered, but they are tough and flexible when moist and dried. Squill should be kept in well-stoppered bottles, on account of its readiness to absorb moisture, when the slices become tough and cannot be reduced to powder. When kept in a dry place, Squill retains its virtues for a long time. When powdered, unless carefully preserved in a dried state by absorption of moisture, it forms a hard mass, and it is therefore officially recommended that powdered Squill should be kept quite dry over quicklime.

Occasionally, entire bulbs are imported, but are difficult to keep in the fresh state as they preserve their vitality for a long time, and if allowed to remain in a warm place, rapidly develop an aerial shoot. Professor Henslow reports (Poisonous Plants in Field and Garden) that a bulb was found attempting to grow after being stowed away for more than twenty years in the museum of St. Bartholomew's Hospital Medical School.

Constituents: The chemical constituents of Squill are imperfectly known. Merck, in 1879, separated the three bitter glucosidal substances Scillitoxin, Scillipicrin and Scillin. The first two are amorphous and act upon the heart, the former being the more active; Scillin is crystalline and causes numbness and vomiting. Other constituents are mucilaginous and saccharine matter, including a peculiar mucilaginous carbohydrate named Sinistrin, an Inulin-like substance, which yields Laevulose on being boiled with dilute acid. The name Sinistrin (in 1834, first proposed by Macquart for Inulin) has also been applied to a mucilaginous matter extracted from barley, but it remains to be proved that the latter is identical with the Sinistrin of Squill. Calcium oxalate is also present, in bundles of long, acicular crystals, which easily penetrate the skin when the bulbs are handled, and causes intense irritation, sometimes eruption, if a piece of fresh Squill is rubbed on the skin.

The toxicity of Squills has more recently been ascribed to a single, bitter, non-nitrogenous glucoside, to which the name Scillitinis given, and which is the active diuretic and expectorant principle.

The bulbs also yield when distilled in a current of steam, a slightly coloured liquid oil of unpleasant odour.

The chemistry of Squills cannot yet be regarded as fully worked out, since most of the glucosides described have only been prepared in an amorphous condition of uncertain chemical identity.

Medicinal Action and Uses: The Medicinal Squill was valued as a medicine in early classic times and has ever since been employed by physicians, being official in all pharmacopoeias. Oxymel of Squill, used for coughs, was invented by Pythagoras, who lived in the sixth century before Christ.

It is mentioned by Theophrastus in the third century before Christ, and was known to all the ancient Greek physicians. Epimenides, a Greek, is said to have made much use of it, from which circumstance we find it called Epimenidea.

It is considered to be the Sea Onion referred to by Homer. Pliny was acquainted with it, and Dioscorides, who lived about the same time, describes the different varieties of the bulb and the method of making vinegar of Squills. A similar preparation, as well as compounds of Squill with honey, was administered by the Arabian physicians of the Middle Ages, who introduced the drug into European medicine, these preparations still remaining in use.

The mediaeval reputation of Squill was originally as a diuretic, the older authorities attributing its diuretic action to a direct stimulant effect upon the kidney.

As a diuretic, it is frequently employed in dropsy, whether due to chronic disease of the kidneys or to the renal congestion consequent to chronic cardiac disease. Squill is not employed, however, when the kidneys are acutely inflamed. In the treatment of cardiac dropsy, Squill is frequently combined with digitalis.

Squill stimulates the bronchial mucous membrane and is given in bronchitis after subsidence of the acute inflammation. It is generally used in combination with other stimulating expectorants, its effects being thereby increased, and is considered most useful in chronic bronchitis, catarrhal affections and asthma. The tincture is administered combined with other expectorants, especially ipecacuanha and ammonium carbonate. Vinegar, Oxymel and Syrup of Squill are also common constituents of expectorant cough mixtures.

It is largely sued for its stimulating, expectorant and diuretie properties, and is alsoa cardiac tonic, acting in a similar manner to digitalis, slowing and strengthening the pulse, though more irritating to the gastro-intestinal mucous membrane. On account of its irritant qualities it is not administered in diseases of an acute inflammatory nature. It has also been given as an emetic in whooping-cough and croup, usually combined with ipecacuanha, but as an emetic is considered very uncertain in its action.

To prevent its too great action on the stomach, it is frequently eombined with a portion of opium. With calomel, it forms a powerful stimulant of the urinary organs. (A pill containing 1 grain each of Squill, digitalis and calomel is popularly known as Niemeyer's pill.)

In poisonous doses, Squill produces violent inflammation of the gastro-intestinal and genito-urinary tracts, manifested by nausea, vomiting, abdominal pains and purging, and, in addition, dullness, stupour, convulsions, a marked fall in temperature, enfeebled circulation and sometimes death.

The powdered drug and extracts made from it have been largely used as rat poisons and are said to be very efficacious, the red variety being preferred for this purpose, although there would not seem to be sufficient evidence of its superiority

Dosage: When given in substance, Squill is most conveniently administered in the form of pill. Dose: 1 to 3 grains.

Vinegar of Squill, B.P. Dose: 5 to 15 minims.

Vinegar of Squill, U.S.P. Average dose: 15 minims.

Liquid Extraet of Squill, B.P. Codex. Dose: 1 to 3 minims.

Fluid Extraet of Squill, U.S.P. Average dose: 1 1/2 minim.

Opiate Linetus, B.P.C. Dose: 1/2 to 1 fluid drachm.

Linctus of Squill, B.P.B. Dose: 1/2 to 1 fluid drachm. (Used as cough linctus for children.)

Syrup of Squill, B.P. Used as an expectorant in acid eough mixtures. Dose: 1/2 1 fluid drachm.

Syrup of Squill, U.S.P. (The preparation commonly administered in bronchitis.) Average dose: 30 minims.

Compound Syrup of Squill, U.S.P. Average dose: 30 minims.

Compound Squill Tablets, B.P.C. Dose: 1 to 2 tablets.

Tincture of Squill, B.P. (Used with other expectorants to relieve cough and in chronic bronchitis.) Dose: 5 to 15 minims.

Tincture of Squill, U.S.P. Average dose: 15 minims.

Compound Linctus of Squill, B.P.C. (Gee's Linctus.) Dose: 1/2 to 1 fluid drachm.

Squill Mixture, B.P.C. (Fothergill's Cough Mixture.) Given for coughs. Dose: 2 to 4 fluid drachms.

Compound Squill Mixture, B.P.C. (Used as diaphoretic and expectorant.) Dose: 1/2 to 1 fluid ounce.

Squill and Ipecacuanha Mixture, B.P.C. Dose: 1/2 to 1 fluid ounce.

Squill and Opium Mixture (Abercrombie's Cough Mixture), B.P.C. Dose: 2 to 4 fluid drachms.

Oxymel of Squill, B.P. (Vinegar of Squill 20, purified honey 50.) Employed in coughs and colds to assist expectoration. Dose: 1/2 to 1 fluid drachm.

Compound Squill Pill, B.P. Dose: 4 to 8 grains.

Compound Syrup of Squill, B.P.C. (For coughs.) Dose: 1/2 to 1 fluid drachm.

Substitutes: There are several bulbs used in place of the official Squill which, owing to the abundance and low price of the latter, do not appear in the European market.

Indian Squill consists of the younger bulbs of Urginea indica (Knuth), or of Scilla indica (Baker), which is also known as Ledebouria hyacinthina (Roth.).

U. indica, Knuth (S. indica, Roxb.) is a widely diffused plant occurring in northern India, Abyssinia, Nubia and Senegambia. It is known by the same Arabic and Persian names as U. scilla and its bulbs are used for similar purposes, but are considered to have no action when old and large. The bulbs consist of whitish, fleshy coats or scales, which enclose each other completely. They resemble common onions in shape.

S. indica, Baker (L. hyacinthina, Roth.), a native of India and Abyssinia, has a bulb often confused in the Indian bazaars with the preceding, but easily distinguished when entire by being scaly, not tunicated, its creamcoloured scales overlapping one another. The bulbs are about the size and shape of a small pear, somewhat smaller than those of U. indica. It is considered a better representative of the European Squill.

The bulbs of both species have a nauseous odour and a bitter acrid taste. They are collected soon after the plants have flowered, divested of their dry, outer, membraneous coats, cut into slices and dried.

The chief constituents in each case are bitter principles, similar to the glucosidal substances found in ordinary Squill, and needleshaped crystals of calcium oxalate are also present.

The drug possesses stimulant, expectorant and diuretic principles, and is official in the India and Colonial Addendum for use in India and the Eastern Colonies as an equivalent of ordinary Squill.

U. altissima, Baker (Ornithogalum altissimum, Linn.), a South African species very closely related to the common Squill, has apparently the same properties.

The bulb of S. Peruviana (Linn.) has also been used and exported as a substitute for Squill.

Drimia ciliaris (Jacq.), native of the Cape of Good Hope, much resembles the official Squill, but has a juice so irritating if it comes into contact with the skin, that it was called by the Dutch colonists Jeukbol, i.e. Itch-bulb. It is used medicinally as an emetic, expectorant and diuretic.

Crinum asiaticum, var. toxicarium (Hubert), is a large plant with handsome white flowers and showy leaves, cultivated in Indian gardens and growing wild in low, humid spots in various parts of India and on the coast of Ceylon. The bulb was admitted in 1868 to the Pharmacopoeia of India as a valuable emetic, but is not widely used.

The European Squills belonging to the genus Scilla possess in a milder form the same active principle, and some of the species are deleterious, if not absolutely dangerous.

The bulbs of S. lilio-hyacinthus are used as a purgative by the inhabitants of the Pyrenees.