Balsam of Peru

Indolent, sluggish wounds or ulcers with thin, foul-smelling discharge that resist ordinary dressings

Widespread scabies itching unresponsive to simpler topical remedies

Overview. Balsam of Peru is the thick, dark brown, vanilla-scented oleoresin obtained from Myroxylon pereirae, a large tree of the Fabaceae family native to the Pacific coastal forests of El Salvador and neighboring Central America. The balsam is collected by scorching and beating strips of bark until the underlying wood exudes resin, which is absorbed onto cloths and later boiled out and pressed. Eclectic physicians of the nineteenth and early twentieth centuries valued it chiefly as a topical antiseptic and stimulant to sluggish healing tissue, using it far more often externally than internally.

Clinical Notes. The balsam finds its main modern use in wound care, applied as a dilute ointment to indolent ulcers, pressure sores, and minor wounds that are slow to granulate. Eclectic writers favored it in mixed preparations for scabies and other parasitic skin conditions, and it was a traditional ingredient in hemorrhoid preparations for its combination of mild anesthetic warmth and antiseptic action.

Therapy. External. Balsam of Peru is a good parasiticide and has given the best of satisfaction in scabies and for the destruction of lice. For the former it may be combined with the sulphurated ointments, or may be used alone, with an oleaginous and petrolatum base (balsam, 25 parts; olive oil, 50 parts; petrolatum, 100 parts).

Action. Skin eruptions have been produced by applying the balsam to the skin, as hives, eczema, and erythema; sometimes the latter results from its internal use. These effects are thought to be due largely to impurities in the factitious drug, which is oftener sold than the genuine balsam.