Alstonia bark (Alstonia Constricta)
Alstonia Constricta
Western Herbalism
Western Herbalism

Alstonia bark

Alstonia Constricta

Also known as Native quinine of Australia, Australian fever bark, Fever bark, Bitter bark, Alstonia, Dita Bark, Devil tree of India.

CoolingDryingTaste: Bitter

Alstonia constricta is a small tree native to the drier woodlands of eastern Australia, long known to colonial settlers and eclectic physicians as a bitter, quinine-like bark. The dried stem and root bark were used from the nineteenth century onward as a substitute for cinchona in intermittent fevers, and as a general bitter tonic for weak digestion. It holds a modest but distinct place in eclectic materia medica as an antimalarial and tonic bitter from the antipodes.

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Actions

Bitter tonicAntiperiodicAntimalarial (traditional)Digestive stimulantFebrifugeAstringentCholagogue (mild)

Indications what the tradition reached for it in

Specific indications

Intermittent or remittent fever with clear-cut chills and sweats, especially where quinine is unavailable or poorly tolerated

Sallow, atonic patient with a heavily furred tongue, poor appetite and sluggish bowels

Safety

Low dose botanical. Used in drop doses in the classical practice; not a plant to dose freely.

Pregnancy: Avoid in pregnancy: indole alkaloid content and lack of modern safety data warrant precaution.

Breastfeeding: Avoid in lactation due to absence of safety data and alkaloid content.

The record lists 3 contraindications; open the plate in the library to read them in full.

In practice

Alstonia bark was reached for by eclectic physicians in cases resembling malaria, particularly where quinine was scarce, poorly tolerated, or where the fever pattern showed the classic periodicity of chills, fever, and sweating in stages.

Dosing as the sources wrote it

PreparationAs writtenMetric
Powdered bark0.1-0.6 g (2-10 grains) up to three times daily100-600 mg
Tincture (1:5)0.6-4 mL (10-60 minims) up to three times daily0.6-4 mL
Specific alstonia (concentrated liquid)0.1-1.3 mL (2-20 minims) up to three times daily0.1-1.3 mL
Action, Medical Uses, and Dosage: The inner bark of Alstonia constricta is said to possess marked antiperiodic properties, while the outer bark is stated to have been efficacious in curing certain forms of rheumatism. Further trials are needed, however, before it can be ranked as a substitute for quinine, or other of the cinchona alkaloids, yet it has proved as efficient in intermittents. "Hesse attributes to alstonidine properties analogous at once to those of quinine and to nux vomica. The experiments of Bancroft and of Bixby prove that this drug is valuable as a tonic febrifuge, and more valuable as a febrifuge than as a tonic, while the Alstonia scholaris is more generally employed against dysentery" (Beringer, Amer. Jour. Pharm., 1895, p. 167).
The inner bark was given to the patients in a dose of from 4 to 8 grains, an hour or two before the expected chill, repeating the dose 2 or 3 times, each time anterior to the anticipated chill.518 mg
barkThe dose of the bark, which should be well masticated, is from 2 to 8 grains; but the more desirable form for administration and efficacy appears to be the powdered bark, in capsules, 2 to 5 grains every 3 or 4 hours; as a tonic, grain doses.130-518 mg

Doses are reproduced from the sources for practitioners and are not a recommendation for any person.

From the sources

Overview. Alstonia constricta is a small tree native to the drier woodlands of eastern Australia, long known to colonial settlers and eclectic physicians as a bitter, quinine-like bark. The dried stem and root bark were used from the nineteenth century onward as a substitute for cinchona in intermittent fevers, and as a general bitter tonic for weak digestion. It holds a modest but distinct place in eclectic materia medica as an antimalarial and tonic bitter from the antipodes.

Clinical Notes. Alstonia bark was reached for by eclectic physicians in cases resembling malaria, particularly where quinine was scarce, poorly tolerated, or where the fever pattern showed the classic periodicity of chills, fever, and sweating in stages.

Therapy. This remedy was brought to the notice of the profession by Dr. John M. Scudder. He regarded it superior in its tonic and restorative properties to calisaya bark in certain specific conditions. His indications were as follows: The tongue inclined to be dirty, skin dark and sallow, the urine depositing a sediment, with a general lack of tone.

Specific Symptomatology. General malarial cachexia, periodicity, fever with marked intermissions or remissions. Malarial fever, with exacerbations. General atony of the glandular organs, with sallow skin, heavily coated tongue and constipation.

Drawn from King's American Dispensatory, 18th edition (Felter and Lloyd); Ellingwood's American Materia Medica, Therapeutics and Pharmacognosy, and the Bountiful Herbs editorial.

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