Quassia

Poor appetite and weak digestion in a debilitated patient who needs a simple bitter to restart the digestive reflex before food is tolerated

Pinworm or threadworm infestation in children, given as a mild enema or oral infusion where gentler anthelmintics are preferred

Overview. Quassia amara is a small tree native to Central America and northern South America, whose intensely bitter heartwood has long been used in the Caribbean and Latin America both as a tonic bitter and as a folk insecticide. Eclectic and earlier European physicians prized it as one of the purest bitters available, largely free of astringency, making it useful where a clean stimulus to appetite and digestion was wanted without additional tannic effect. The wood is typically prepared as a cold infusion, tincture, or fluid extract, and quassin, its principal bitter constituent, remains a reference standard for bitterness in pharmacognosy.

Clinical Notes. Quassia is one of the cleanest bitters in the old materia medica: pour cold water over shaved wood or chips and let it stand, and the resulting infusion is bitter but not astringent, gentle enough for a weak or convalescent stomach.

Action and Therapy. Quassia is a bitter stomachic and tonic. A cold infusion (1 to 100 of cold water) used as an injection is one of the most useful agents to remove ascarides. An acidulated infusion may be employed to lessen the craving for alcoholics.

Therapy. It is one of the best of what is known as “stomach bitters.” In debility of the stomach or intestinal structures, and inactivity of the secreting organs, the tonic effects of this agent are most pronounced.