Papaya. Carica papaya.

Synonyms—Papaw, Pawpaw, Melon-tree.

Part Employed—An active principle obtained from the juice of the unripe fruit.

CONSTITUENTS—

The active principle has been variously named papain, papaotin, papoid or caroid. It is precipitated by alcohol, is a nitrogenous principle approximating in character a true albuminoid, and is associated with vegetable peptones and a milk-curdling ferment.

Description and Administration—It is a powder of cream-white color, almost odorless and with but little taste. It is easily soluble in water and also in glycerine. Dose, from one to three grains. A larger dose may be given where immediate effects are desired, but is seldom necessary. It is sometimes advisable to repeat the dose in from one to two hours.

The natives have long had a custom of wrapping fresh meat in the leaves of the pawpaw, claiming that it prevented decomposition, softening it and materially assisting its digestion. They also applied the juice to open and offensive wounds, to cleanse them and promote healing.

Therapy—The indications for the use of papoid in treating digestive disorders may be summarized somewhat as follows:

Actual and relative deficiency of the gastric juice or its constituents.

(a) Diminished secretion of gastric juice as a whole; apepsia, anemia and deficient blood supply; wasting diseases.

(b) Diminished proportion of pepsin; atonic dyspepsia; atrophy of gastric tubules.

(c) Diminution of hydrochloric acid—achlorhydria; carcinoma.

(d) Relative deficiency of gastric juice; overfeeding.

In gastric catarrh.

(a) Where there is tenacious mucus to be removed, thus enabling the food to come in contact with the mucous membrane.

(b) Where there is impaired digestion.

In excessive secretion of acid, to prevent duodenal dyspepsia.

In gastralgia, irritable stomach, nausea or vomiting.

In intestinal disorders.

(a) In constipation due to indigestion; in diarrhea, as a sedative.

(b) In intestinal worms. (This claim the writer has not personally verified, but as the intestinal mucus which shields the worms is removed by papoid, it is easily understood that their destruction would naturally result, or would be more readily accomplished after its administration.) Hutchinson treated tapeworm successfully with five grains of the dried juice twice daily.

In infectious disorders of the intestinal tract.

(a) Where there is abnormal fermentation, by its antiseptic action, which may be heightened by combination.

(b) Where there are foreign substances present, its detergent effect may be utilized in clearing these out from the intestinal canal by their digestion.

In infantile indigestion. Here papoid not only readily peptonizes cow's milk, but the resulting curds are also rendered soft and flocculent, resembling those of breast milk.

In case of obstruction of the esophagus by the impaction of a piece of meat or gristle, a paste of papoid and water produces softening in a short time.

Nearly all of the above statements have been confirmed in the experience of the writer during ten or twelve years' constant use of the agent, alternated with, but seldom in conjunction with the animal ferment.

Where papoid or any form of pawpaw is used as a digestive agent, there may be observed an increase in the amount of uric acid when that substance is deficient, and if oxalates are present they are diminished.

It is a reliable remedy for general distress or pain in the stomach and bowels during the process of digestion. It can be prescribed almost without discrimination in these cases, and the results are in some cases surprising. It may be given during the meal, and pain not occur for an hour. At that time, its influence being probably spent, another dose will continue the effects of the first. Its effects become permanent usually in acute or subacute cases after a few days, when it may be discontinued.

It is not a remedy for pain occurring before meals or after the food is digested, or for gastric pain occurring without regard to the taking of food—continuous pain and distress—since these pains are either neuralgic or organic in character. The agent is specifically one for functional disorder. It is a most valuable agent in catarrh of the stomach and in the digestive failure accompanying continued fevers. It stimulates the stomach in the beginning of convalescence, and in some cases increases the appetite and promotes absorption of the digested pabulum.

It is serviceable in the digestive disorders of pregnancy, stimulating appropriation and assimilation. In those cases where the digestion is seriously interfered with during the last three months of pregnancy, it being almost impossible, because of the great pain induced, for the patient to take any food into the stomach, the condition will be entirely relieved by this agent within a few days, the patient being enabled to eat large meals of meat without discomfort and with satisfaction.

The agent is a solvent of fibrin, and has been used to dissolve false membranes, old hardened tissue, warts, and tumors, and has been satisfactorily applied to epithelioma.

Mortimer Granville reports several cases of cancer of the stomach treated very satisfactorily with this agent. In diphtheria the powder serves a most useful purpose in dissolving and permitting the removal of the densest exudate, which in some cases covers the pharynx and naso-pharynx, and occludes the nares. Good results have been reported by Jacobi, Hubert and others, and have come under our own observation. Kota and Asche are reported in the Prescription as having observed more than a hundred cases treated with success by this method.

Empirically it has been used in a few cases of nephritic colic with the most marked results. It will diminish the formation of the oxalates, al. though in cases where tried there has been an increase in uric acid.

The American Materia Medica, Therapeutics and Pharmacognosy, 1919, was written by Finley Ellingwood, M.D.
It was scanned by Michael Moore for the Southwest School of Botanical Medicine.