Common name: Ipecac

Ⅰpecac is a forest-dwelling shrub and medicinal plant originating in tropical America, its natural range extending from Nicaragua, Costa Rica and Panama in Central America to the state of Minas Gerais in southeastern Brazil. 

Presently, it is cultivated in India and its native Costa Rica and Nicaragua but is still wild-harvested in South America. 

There appear to be two subspecies, formally recognised as separate species, subsp. acuminata originating in Central America and subsp. ipecacuanha originating in South America, both of which are valued for the alkaloids produced in their roots. 

It forms a shrub 30 to 50 cm (1 to 1.6 ft) tall, occasionally to 80 cm (2.6 ft), with a slender, usually crooked main stem. The underground parts consist of false rhizomes with horizontally spreading fibrous roots.

The leaves are few, oval with a pointed tip, 5 to 9 cm (2 to 4 in) long, dark glossy green, prominently ribbed on top, and in pairs that attach by their stalk directly to the stem.

The flowers are small, white, trumpet-shaped and borne in rounded clusters. They bloom in the rainy season, followed by oval fruit around 0.5 cm (0.2 in) in diameter. Green when young, they become dark purple when ripe, with two small seed inside. 

Use

The roots contain alkaloids, of which 'Emetine' is the most important from a pharmaceutical perspective and is the principal component, consisting of up to 75% of the overall alkaloid content. However, the emetine content varies widely between the different subspecies and cultivated and wild-sourced plants. 

Among the plants with the highest concentrations of emetine are those cultivated in Costa Rica and Nicaragua. However, the reason for this is not fully understood. Neither is how much influence is brought to bear by the subspecies, variety or cultivation practice.

Health use

Emetine is a strong amoebicide, and native people have long used the roots to treat intestinal parasites. It is also given as an expectorant to loosen and expel mucus from the respiratory tract.

In large doses, it is used as an emetic to cause vomiting in cases of a drug overdose and in young children that have swallowed a foreign object. However, it is never given when the ingested substance is an alkali, cleaning product, strong acid, strychnine or petroleum distillate. 

Emetine is sometimes added to medicinal alcohol as a denaturant to discourage consumption. In very small amounts, it is used to stimulate the appetite.

General interest

Louis XIV of France reportedly owed his life to the actions of emetine after being struck down with dysentery when there were few, if any, other effective treatments for the ailment.

Climate

Grows naturally as an understory shrub in humid subtropical and tropical climates, generally frost-free areas with annual lows of 15 to 25°C, annual highs of 22 to 33°C, annual rainfall of 1500 to 5000 mm and a dry season of 4 months or less, extending to 5 months with irrigation.

Ipecac is cultivated In India as an understory crop, particularly in Cinchona (Cinchona calisaya) plantations and mainly in Darjeeling District, West Bengal, at elevations of up to 1200 m (3900 ft), in areas where the average low of the warmest month is 19°C (66°F) or above.

Growing

New plants can be started from seed or cuttings. Still, cuttings are preferred because the plants give more predictable results in their alkaloid and emetine content. 

Cultivation in Costa Rica and Nicaragua involves clearing an area of forest but leaving some trees for shading. However, only trees with small leaves are left standing because they effectively break up the rain into small droplets that do not damage the crop.

The soil beneath the trees is then dug up, mounded into raised beds and planted with freshly-cut cuttings, each about 8 cm (3.2 in) long and with a planting density of roughly two hundred per square meter. Planting is done in the rainy season, and the beds weeded at six-month intervals for three to four years or until the roots are ready for harvesting.

The roots are harvested when the plant comes into flower in the rainy season. At this time, the alkaloid content is highest and the soil moist and loose, making it easily dug without damaging the roots. After the roots are harvested, they are cleaned, dried in the sun, bagged and then transported, or are stored awaiting processing.

Yields of about 6000 kgs (13,228 lbs) of fresh roots per hectare are reported for three-year-old crops grown in plantations in India. Overall alkaloid content is in the range of 2 to 4%.

Performs best on deep, rich, free-draining loam and sand soils of a moderately acid to neutral nature, generally with a pH of 5.0 to 7.0, and under light to medium shade conditions. It has poor tolerance to direct sunlight and needs shaded conditions to survive and grow.

Problem features

Birds eat the fruit and disperse the seed, sometimes a far distance from the parent plant. It is reported as having naturalised in China. Still, there does not appear to be any record of it anywhere as a weed or invasive species. It probably would not survive direct sunlight but could develop as a problem weed in shaded areas such as in understory environments in humid forests.

Ipecac should only be administered under medical supervision. And the unprocessed and unrefined rhizomes and roots never consumed. Deaths have resulted from improper use and overdose. Besides vomiting, side effects include diarrhoea, hypertension, neuromuscular symptoms, circulatory failure and severe heart palpitations.

Books

• Alexiades, M.N. & Shanley, P. 2005, Forest products, livelihoods and conservation: case studies of non-timber forest product systems, volume 3 (Latin America), Bogor, Indonesia

• Chevallier, A. 2000, Encyclopedia of herbal medicine, 2nd American ed., Dorling Kindersley, New York

• Culbreth, D. M. R. 1927, A manual of materia medica and pharmacology : comprising the organic and inorganic drugs which are or have been recognized by the United States pharmacopeia, 7th ed., Febiger, Philadelphia

• Farooqi, A. A. & Sreeramu, B. S. 2004, Cultivation of medicinal and aromatic crops, Hyderabad University Press, Hyderabad

• Food and Agriculture Organization of the United Nations (FAO) 1986. Some medicinal forest plants of Africa and Latin America, Forest Resources Development Branch, Rome, Italy

• Hill, A. F. 1952, Economic botany : a textbook of useful plants and plant products, 2nd ed, McGraw-Hill, New York

• Khan, I. A. & Abourashed, E. A. 2010, Leung's encyclopedia of common natural ingredients : used in food, drugs and cosmetics, 3rd edition, Wiley Publishing, Hoboken, New Jersey

• Lopez, C., et al. 2004, Riches of the forest: fruits, remedies and handicrafts in Latin America, Center for International Forestry Research (CIFOR), Bogor, Indonesia

• Mors, W. B & Rizzini, C. T. 1966, Useful plants of Brazil, Holden-Day Publishing, San Francisco, California

• Randall, R. P. 2002, A global compendium of weeds, R.G. and F.J. Richardson Press, Melbourne

• Randall, R. P. 2007, The introduced flora of Australia and its weed status, Cooperative Research Centre for Australian Weed Management, Glen Osmond, South Australia