Honduras bark

Chronic pustular eruption of syphilitic origin appearing in a run-down, debilitated patient

Weak, easily irritated stomach with poor appetite in a patient needing a mild bitter before deeper alterative treatment is tolerated

Overview. Cascara Amarga, botanically Picramnia antidesma, is a small tree or shrub of the family Picramniaceae native to Central America, the Caribbean, and parts of northern South America. The bark, sometimes traded as Honduras bark, was used by nineteenth century eclectic physicians as a bitter alterative distinct from the unrelated Rhamnus purshiana (Cascara Sagrada), which is a laxative bark from a different plant family entirely. In the eclectic materia medica it held a niche place as a gentle tonic and blood purifier for chronic skin disease, particularly where syphilis was suspected as an underlying cause.

Clinical Notes. Eclectic writers reached for Cascara Amarga in cases of chronic, pustular skin disease occurring against a background of general debility, most often where a syphilitic history was present or suspected.

Cascara Amarga, sometimes known as Honduras Bark, is advised in syphilis as an active alterative. The line of its action is where there is chronic skin affection or where the pustular variety of the syphiloderm prevails, the conditions being induced by debility, thus needing a specific tonic influence. It soothes the stomach, overcomes sensitiveness or ready irritability of this organ, increases the appetite, and improves general tonicity.