This is Starwest's nitrogen-flushed double wall silverfoil pack.

Also called California Buckthorn.

Used as an infusion, decoction, extract and tincture.

The 1997 Commission E on Phytotherapy and Herbal Substances of the German Federal Institute for Drugs recommends Cascara Sagrada for 'Constipation.'

'Contraindications: Intestinal obstruction, acute intestinal inflammation... Children under 12 years of age, pregnancy. Side Effects: In single incidents, cramp-like discomforts of the gastrointestinal tract. These cases require a dosage reduction.'

'Special Caution for Use: Stimulating laxatives must not be used over an extended period of time (1 - 2 weeks) without medical advice. The preparation should be used only if no effects can be obtained through change of diet or use of bulk-forming products.'

'Dosage: Cut bark, powder or dry extracts for teas, decoction, cold maceration or elixir. Liquid or solid forms of medication exclusively for oral use. 20 - 30 mg hydroxyanthracene derivatives daily, calculated as cascaroside A. The individually correct dosage is the smallest dosage necessary to maintain a soft stool.'

'The fresh bark contains free anthrone and must be stored for one year or artificially aged by heat and aeration. The use of illegally processed cascara sagrada bark, e.g., fresh bark, will cause severe vomiting, possibly spasms.'

Cascara bark is high in unique 'cascarosides,' as well as resins, tannins, and lipids. Cascarosides have a cathartic action, inducing the large intestine to increase its muscular contraction.

Grieve's classic 'A Modern Herbal': 'Cascara Sagrada is a mild laxative, acting principally on the large intestine. It is considered suitable for delicate and elderly persons, and may with advantage be given in chronic constipation, being generally administered in the form of the fluid extract.'

'It acts also as a stomachic tonic and bitter, in small doses, promoting gastric digestion and appetite.'

King's 1898 Dispensatory: 'Cascara sagrada, when introduced as a medicine, was highly recommended as a certain remedy in cases of habitual constipation, and in some forms of indigestion. Further trial has substantially sustained these assertions, and it is, undoubtedly, a valuable addition to our list of therapeutical agents.'

'It does not, however, succeed in all cases, but acts best where a tonic to the intestines is required. As it tones the whole intestinal tract, it is valuable in doses of 10 drops, after meals, for that dyspeptic condition which depends most largely upon constipation, and is due to intestinal weakness.'

'Administered in large doses, it has served us nicely in sick headache, due to like causes. Loss of tone in the rectum, with constipation, giving rise to hemorrhoids, is benefited by it.'

'In chronic constipation it may be necessary to begin with the larger doses, and gradually reduce the quantity to a few drops, 3 times a day, though, as a rule, it is better to give repeated small doses, gradually increased, until the desired action is obtained, and then to gradually withdraw the drug.'

'It acts kindly without irritating or griping, and produces stools of a semifluid consistence. Occasionally, but rarely, have reports of harsh action been made, such as cramps, colic, vomiting, and inordinate catharsis, while a soreness of the bowels, persistent in character, has been attributed to it. These effects, however, are not common.'

'The remedy, in 10 to 15-drop doses, has been used with asserted success in rheumatism. Chronic diarrhoea, when due to hepatic sluggishness, has been checked by this agent, and it is said to be of some value in gastric, duodenal, and biliary catarrh, with jaundice.'

'It is commonly prepared in the form of a fluid extract, the dose of which is from 10 to 60 minims, repeated, a required, 2 or 3 times a day. The powder may be given in 5-grain doses; the solid extract in 2 or 3-grain doses.'

American Materia Medica, 1919 (Ellingwood): 'Large doses of the agent produce colic and are seldom needed. In the temporary constipation of pregnancy or in the convalescence of acute disease, doses of from one-fourth to one-half dram in a tonic mixture, preferably of malt extract, taken at the bed hour will be most satisfactory. Often a single dose followed by a glass of cold water on rising will have a salutary effect. This is true of constipation extending over a short period, not necessarily chronic. To produce an immediate effect as a physic, a dram of the fluid extract should be given, and it will probably induce some pain.'

'The agent should not be used in this active form for its immediate effects during the pregnant term, as its irritating influence may be sufficient to produce miscarriage.'

'Cascara in medium doses is an efficient agent in gastric or intestinal catarrh. It quickly restores the normal tone of the mucous membranes, suspending undue secretion and acting in perfect harmony with other measures adopted.'

'It is a useful remedy in many cases of chronic indigestion and in chronic disease of the liver. It has been used in cirrhosis with the best of results. It is useful in jaundice with deficient excretion of bile, and corrects catarrh of the bile duct. It is useful in diarrhea, subacute or chronic, depending on deficient liver action, and upon catarrhal and atonic conditions of the intestinal tract.'