Carminatives

CARMINATIVES [Carminativa (from Latin carminare-to comb wool, clean, purify), or Physetica (from Greek physao-I blow, I expel)]. By this name are meant such agents which free the intestines, as well as the stomach, from gases (the old Russian term 'vetry'). Various medicinal substances possess this action to a certain degree, but in the narrow sense of the word, the term C. s. is usually applied only to essential oils, waters, tinctures and extracts from a specific group of plants, which include, for example, anise, dill, caraway, mint and many others. Many hypotheses have been expressed regarding the mechanism of carminative action, which have not lost their interest even at the present time due to the uncertainty of this question. All of them approach the solution of the question from the point of view of the local action of these agents, since nothing is known about any resorptive carminative action. It is believed that, 1) due to mild irritation of the walls of the stomach and intestines, as well as (reflexively) due to the smell and taste of C. s., the secretion of digestive glands is enhanced, which leads to improved digestion; however, it should be kept in mind that the activity of digestive enzymes (e.g., pepsin) is inhibited by them; 2) due to anti-enzymatic and antiseptic action, substances of this group limit abnormally developed processes of fermentation and putrefaction in the intestines, thereby reducing the formation of gaseous products; 3) according to the experiments of Brandl, the absorption of 7B8 soluble substances, e.g., sugar, salt, peptones, in the presence of C. s. is accelerated, so that the stomach empties more quickly; to a lesser extent this also occurs in the intestines; 4) small amounts of C. s., due to mild irritation, enhance intestinal peristalsis, especially when the walls are flaccid (atonic), and lead to more rapid removal of accumulated gases outward; while the movements and tone of the stomach are decreased. It is possible that the sphincters of the gastro-intestinal channel relax under their influence (local or reflex), whereby a feeling of relief occurs, spasmodic pains disappear, and eructation of gases appears. C. s. are used only in cases where there are no obvious signs of irritation, inflammation or ulceration of the stomach, intestines and peritoneum. Usually they are given only in small doses repeatedly, but even then with caution due to their local irritating action. Small amounts of C. s. are sometimes added to preparations of strong laxatives to reduce the pain and colic that may appear. In large doses, C. s. can also have a general effect on the body, which is observed, however, very rarely. The most common C. s. are the following: 1. Oleum Anisi, essential oil from the fruits of anise (Pimpenella Anisum L.) or star anise (Illicium anisatum Hook); internally 1-6 drops. 2. Fructus Anisi, fruits of anise; internally 0.5-1.5 in powders, pap, mixtures and infusions (5.0-15.0:100.0), especially in pediatric practice. 3. Oleum Foeniculi, essential oil from the fruits of common fennel (Foeniculum vulgare Miller); internally 1-4 drops as Elaeosaccharum, in oil solution. 4. Aqua Foeniculi, aqueous distillate from fennel fruits; internally per se (by teaspoonfuls) or as a constituent of mixtures, especially in pediatric practice. 5. Oleum Carvi, essential oil from the fruits of caraway (Carum Carvi); internally 1-3 drops several times a day. 6. Aqua Carvi, distillate from caraway fruits; internally as an addition to carminative mixtures. 7. Oleum Menthae piperitae, essential oil from the leaves and flowering shoots of peppermint (Mentha piperita L.); internally 1-3 drops per se, several times a day, as Elaeosaccharum, in ether and alcohol solutions, often as an addition to mixtures. 8. Aqua Menthae piperitae, distillate from mint leaves with water; internally as an addition or constituent to mixtures. 9. Preparations from numerous other plants or mixtures of them (official in some countries), e.g., Rx. Fol. Menthae pip., Fol. Melissae, Flor. Chamomillae aa 10.0. M. f. species. DS. 1 teaspoon to a cup of hot water. Lit.: Vinz S., Lectures on Pharmacology, SPB, 1893; Cushny A., A text-book of pharmacology and therapeutics, London, 1924; Poelston E., Lehrbuch der Pharmakologie, Leipzig, 1925; Ewald C. u. Heffter K., Handbuch der all-gemeinen und speziellen Arzneiverordnungslehre, Berlin, 1911.